Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | ME08744 | FL |
NPI | 1023013588 |
---|---|
Provider Name | James D Melton JR. |
First Address | Lakeland, FL 33803-3818 |
Second Address | Lakeland, FL 33803-3818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 02/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
045233500 | (05) | FL |
D64464 | (02) | FL |