Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 93-421 | NM |
N | 207VX0201X | Gynecologic Oncologist | MD60215295 | WA |
NPI | 1306871462 |
---|---|
Provider Name | Mr. Joel Clark Webb |
First Address | Albuquerque, NM 87109-2117 |
Second Address | Albuquerque, NM 87109-2117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 30/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6994499 | STATE OF UTAH DOPL (01) | UT |
9601516 | MED LICENSE (01) | NC |
MD60215295 | WASHINGTON MD LICENSE (01) | WA |