Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 40199 | KY |
NPI | 1942229166 |
---|---|
Provider Name | Dr. James Paul Maynard |
First Address | Burlington, KY 41005-8501 |
Second Address | Fort Thomas, KY 41075-1793 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 09/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2696435 | (05) | OH |
64127350 | (05) | KY |
F28924 | (02) | KY |