Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 11014633A | IN |
N | 2082S0105X | Plastic Hand Surgeon | FT434 | KY |
N | 2086S0105X | Surgery of the Hand | 11014633A | IN |
Y | 2086S0105X | Surgery of the Hand | 4301097509 | MI |
N | 2086S0105X | Surgery of the Hand | FT434 | KY |
NPI | 1124275698 |
---|---|
Provider Name | Dr. James Clarkson |
First Address | East Lansing, MI 48824-7015 |
Second Address | East Lansing, MI 48823-5306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2008 |
Last Update Date | 04/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1124275698 | (05) | MI |