Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 2012018322 | MO |
N | 2086S0102X | Surgical Critical Care | 2012018322 | MO |
NPI | 1063449676 |
---|---|
Provider Name | Dr. Mollie Marie James |
First Address | Joplin, MO 64804-1563 |
Second Address | Joplin, MO 64804-1563 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 25/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063449676 | (05) | MO |
200974630A | (05) | KS |