Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 34007386 | OH |
N | 208600000X | Surgeon | 34007386 | OH |
Y | 2086X0206X | Surgical Oncologist | 340073869 | OH |
NPI | 1245288422 |
---|---|
Provider Name | James R Ouellette |
First Address | Moraine, OH 45439-1924 |
Second Address | Centerville, OH 45459 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 01/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2192550 | (05) | OH |
H26321 | (02) |