Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 14057 | MD |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DS0000009088 | TN |
N | 204E00000X | Oral & Maxillofacial Surgeon | 30021966 | OH |
NPI | 1356305569 |
---|---|
Provider Name | Dr. James M. Christian |
First Address | Memphis, TN 38133-3513 |
Second Address | Memphis, TN 38133-3513 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 25/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2526270 | (05) | OH |
U17616 | (02) | OH |