Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 2009019548 | MO |
Y | 204F00000X | Transplant Surgeon | 22185 | MS |
N | 204F00000X | Transplant Surgeon | MD154953 | OR |
NPI | 1710034509 |
---|---|
Provider Name | Dr. Truman Markley Earl |
First Address | Jackson, MS 39216-4500 |
Second Address | Jackson, MS 39216-4500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 16/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2392654 | (05) | LA |
P01245362 | RR MEDICARE (01) | MS |