Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 043546 | GA |
N | 207VG0400X | Gynecologist | 00022099 | AL |
NPI | 1518071182 |
---|---|
Provider Name | Dr. James John Bendell |
First Address | Lagrange, GA 30240-3144 |
Second Address | Lagrange, GA 30240-3144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 25/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000773924A | (05) | GA |