Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0200X | Infectious Disease | 34292 | SC |
Y | 207RI0200X | Infectious Disease | TP652 | KY |
N | 208000000X | Pediatrician | 29910 | AL |
N | 208000000X | Pediatrician | 34292 | SC |
N | 2080P0208X | Pediatric Infectious Diseases | TP652 | KY |
NPI | 1538327481 |
---|---|
Provider Name | James Aaron Grubbs |
First Address | Atlanta, GA 30374-3904 |
Second Address | Lexington, KY 40536-4053 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2008 |
Last Update Date | 08/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
137020 | (05) | AL |
137144 | (05) | AL |
342926 | (05) | SC |