Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 14766 | AL |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 14766 | AL |
N | 207YP0228X | Pediatric Otolaryngology | 14766 | AL |
N | 207YS0123X | Facial Plastic Surgeon | 14766 | AL |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 14766 | AL |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 14766 | AL |
NPI | 1740268259 |
---|---|
Provider Name | Dr. James Michael Mcqueen |
First Address | Enterprise, AL 36331-1307 |
Second Address | Enterprise, AL 36330-2511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2006 |
Last Update Date | 27/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000024284 | (05) | AL |
E45289 | (02) | AL |