Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | PO 3286 | FL |
N | 213ES0103X | Foot & Ankle Surgery | PO 3286 | FL |
NPI | 1043496409 |
---|---|
Provider Name | Dr. John Andrew Maupin JR. |
First Address | Oklahoma City, OK 73118-5905 |
Second Address | Oklahoma City, OK 73118-5905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2008 |
Last Update Date | 16/01/2008 |