Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 982 | SC |
Y | 207Q00000X | Family Doctor | MD34378 | AL |
N | 207VX0000X | Obstetrician | 34378 | AL |
NPI | 1104188697 |
---|---|
Provider Name | Nicole D Arthur |
First Address | Tuscaloosa, AL 35401-7419 |
Second Address | Bay Minette, AL 36507-4163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2012 |
Last Update Date | 03/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102I168344 | (02) | AL |
176594 | (05) | AL |