Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 9298 | KY |
N | 122300000X | Dentist | 9501 | TN |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 210 | OK |
N | 204E00000X | Oral & Maxillofacial Surgeon | 6913 | OK |
N | 204E00000X | Oral & Maxillofacial Surgeon | 9298 | KY |
NPI | 1174878417 |
---|---|
Provider Name | Dr. James Michael Harlan |
First Address | Oklahoma City, OK 73139-9406 |
Second Address | Oklahoma City, OK 73139-9406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2012 |
Last Update Date | 09/02/2021 |