Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | ME29135 | FL |
NPI | 1053317875 |
---|---|
Provider Name | James B Slattery |
First Address | Newberry, FL 32669-3074 |
Second Address | Gainesville, FL 32607-2245 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 06/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D50055 | (02) | FL |