Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2007014099 | MO |
Y | 208000000X | Pediatrician | 36818 | GA |
N | 208000000X | Pediatrician | MD48977 | TN |
N | 2080P0203X | Pediatric Critical Care Doctor | 2007014099 | MO |
N | 2080P0203X | Pediatric Critical Care Doctor | MD48977 | TN |
NPI | 1255311015 |
---|---|
Provider Name | James H Mccrory |
First Address | Nashville, TN 37232-0001 |
Second Address | Fort Gordon, GA 30905-5741 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 27/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000531924AD | (05) | GA |
119001001 | (05) | AR |
202888913 | (05) | MO |
D52670 | (02) | |
P00437866 | RR MEDICARE # (01) | MO |