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Individual
DR. JIMMY FOSTER MAXWELL
Active
Individual
DR. JIMMY FOSTER MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., P.C.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN009648
GA
122300000X
Dentist
DN9728
FL
122300000X
Dentist
DS0000007704
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00245341A4
—
GA
01
—
RPH011407
PHARMACY LICENSE
GA
Enumeration date
03/25/2010
Last updated
03/25/2010
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