Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 27500 | IA |
NPI | 1023126141 |
---|---|
Provider Name | James Lester Dummett |
First Address | Mason City, IA 50402-1877 |
Second Address | Mason City, IA 50401-1581 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0063222 | (05) | IA |
E47225 | (02) |