Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | E4445 | AL |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 4445 | AL |
NPI | 1255371308 |
---|---|
Provider Name | Dr. James J Link |
First Address | Tuscaloosa, AL 35404-2983 |
Second Address | Tuscaloosa, AL 35404-2983 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 27/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000077373 | (05) | AL |
T87650 | (02) | AL |