Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 7086 | NE |
N | 1223D0001X | Dental Public Health | 7086 | NE |
Y | 1223G0001X | General Practice | 7086 | NE |
Y | 213EG0000X | General Practice | 7086 | NE |
NPI | 1083050066 |
---|---|
Provider Name | Dr. James D Hadden |
First Address | Chadron, NE 69337-2366 |
Second Address | Chadron, NE 69337-2366 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2013 |
Last Update Date | 28/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7086 | (05) | NE |