Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 01038146A | IN |
N | 207VG0400X | Gynecologist | 01038146A | IN |
NPI | 1104834993 |
---|---|
Provider Name | Dr. James C. Webb |
First Address | Greenwood, IN 46143-1070 |
Second Address | Greenwood, IN 46143-1070 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 14/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100350310 | (05) | IN |