Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0122X | Plastic and Reconstructive Surgery | 19413 | WV |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 35060019 | OH |
NPI | 1306831177 |
---|---|
Provider Name | Dr. James R Shope |
First Address | Martins Ferry, OH 43935-1648 |
Second Address | Martins Ferry, OH 43935-1648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2005 |
Last Update Date | 18/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0114218000 | (05) | WV |
0939524 | (05) | OH |
F68113 | (02) | |
P00422394 | RAILROAD MEDICARE (01) | OH |