Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 2713 | OK |
NPI | 1093742702 |
---|---|
Provider Name | James E Magnusson |
First Address | Norman, OK 73070-0039 |
Second Address | Norman, OK 73069-6301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 17/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F84015 | (02) | OK |