Individual
JAMES THOMAS MAIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1854 BROADWAY ST, CAPE GIRARDEAU, MO 63701-4553
(573) 335-1402
Mailing address
1854 BROADWAY ST, CAPE GIRARDEAU, MO 63701-4553
(573) 335-1402
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
000500
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3018793000
—
MO
Enumeration date
01/03/2006
Last updated
07/14/2010
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