Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | M4335 | TX |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 23070 | AL |
NPI | 1396821161 |
---|---|
Provider Name | Susan Dixon Mccammon |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 12/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
179277201 | (05) | TX |
H23440 | (02) | TX |