Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 35.138736 | OH |
NPI | 1154764363 |
---|---|
Provider Name | James David Brockett |
First Address | Akron, OH 44307-2433 |
Second Address | Akron, OH 44307-2432 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2013 |
Last Update Date | 09/03/2020 |