Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 4318 | IA |
N | 207R00000X | Internist | 4318 | IA |
N | 111NI0900X | Internist | 4318 | IA |
N | 208000000X | Pediatrician | 4318 | IA |
NPI | 1184882102 |
---|---|
Provider Name | Dr. James Philson |
First Address | Des Moines, IA 50312-4104 |
Second Address | Des Moines, IA 50312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2008 |
Last Update Date | 12/02/2020 |