Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204E00000X | Oral & Maxillofacial Surgeon | 79392 | GA |
Y | 204E00000X | Oral & Maxillofacial Surgeon | DN015554 | GA |
N | 204E00000X | Oral & Maxillofacial Surgeon | DNGA000670 | GA |
N | 204E00000X | Oral & Maxillofacial Surgeon | ME119237 | FL |
N | 208200000X | Surgeon | 2018-02491 | NC |
N | 208600000X | Surgeon | 2018-02491 | NC |
NPI | 1225202484 |
---|---|
Provider Name | Dr. Jeffrey Nelson James |
First Address | Augusta, GA 30912-1270 |
Second Address | Augusta, GA 30912-5536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2008 |
Last Update Date | 25/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003200149D | (05) | GA |
ZX9392 | (05) | SC |