Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 2001014708 | MO |
N | 2081P2900X | Pain Medicine | 2001014708 | MO |
NPI | 1417916222 |
---|---|
Provider Name | James Dale Toombs |
First Address | Columbia, MO 65201-5275 |
Second Address | Columbia, MO 65201-5275 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H40595 | (02) | MO |