Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 23944 | IA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 23944 | IA |
NPI | 1295732931 |
---|---|
Provider Name | Jeffrey S Carithers |
First Address | Des Moines, IA 50312-3503 |
Second Address | Des Moines, IA 50312-3503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 23/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0244368 | (05) | IA |
A03222 | (02) | IA |