Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 19069 | TX |
N | 122300000X | Dentist | 2002031815 | MO |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 2002031815 | MO |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 2002001967 | MO |
N | 208200000X | Surgeon | 2002001967 | MO |
N | 208600000X | Surgeon | 2002001967 | MO |
NPI | 1538272976 |
---|---|
Provider Name | Dr. James Adam Andrews |
First Address | Columbia, MO 65203-5661 |
Second Address | Columbia, MO 65203-5661 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 02/06/2016 |