Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204E00000X | Oral & Maxillofacial Surgeon | 33897 | IA |
Y | 208200000X | Surgeon | 33897 | IA |
Y | 208600000X | Surgeon | 33897 | IA |
NPI | 1467431213 |
---|---|
Provider Name | Dr. James F Paul |
First Address | Davenport, IA 52807-3461 |
Second Address | Davenport, IA 52807-3461 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 24/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0244574 | (05) | IA |
036104275 | (05) | IL |
H38754 | (02) | IA |