Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | RES.003993 | OH |
NPI | 1962988162 |
---|---|
Provider Name | James Taylor |
First Address | Hilliard, OH 43026-3863 |
Second Address | Columbus, OH 43210-1267 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2018 |
Last Update Date | 11/07/2018 |