Individual
DR. JAMES A MAXWELL JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS,MS (R)
Contact information
Practice address
2210 OLYMPIC ST, SPRINGFIELD, OH 45503-2737
(937) 399-4476
(937) 399-9623
Mailing address
2210 OLYMPIC ST, SPRINGFIELD, OH 45503-2737
(937) 399-4476
(937) 399-9623
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30-015780
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000075860
ANTHEM
OH
05
—
0466839
—
OH
05
—
311107160026
—
OH
05
—
6082
—
OH
Enumeration date
03/15/2006
Last updated
07/09/2007
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