Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | DS3297 | TN |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 3297 | TN |
NPI | 1366435711 |
---|---|
Provider Name | Dr. Paul Thomas Mccord |
First Address | Cleveland, TN 37311-3874 |
Second Address | Cleveland, TN 37311-3874 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 05/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2009217 | BCBS TN (01) | TN |
439950 | UNITED CONCORDIA (01) | TN |
T74063 | (02) | TN |