Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 3104 | AK |
N | 207X00000X | Orthopaedic Surgeon | AK3104 | AK |
NPI | 1023122991 |
---|---|
Provider Name | Jimmy M. Tamai |
First Address | Fairbanks, AK 99707-1179 |
Second Address | Fairbanks, AK 99701-3175 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 22/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F82382 | (02) | AK |
MD31041 | (05) | AK |
MD31042 | (05) | AK |
MDG049 | (05) | AK |