Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 34-00-4252 | OH |
NPI | 1023095726 |
---|---|
Provider Name | Dr. James K Matheson |
First Address | Amherst, OH 44001-1131 |
Second Address | Amherst, OH 44001-1131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2005 |
Last Update Date | 25/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0762652 | (05) | OH |
E76617 | (02) |