Basic Information
| Provider Information | |||||||||
| NPI: | 1689714024 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAXWELL | ||||||||
| FirstName: | JAMES | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 CARSON ST | ||||||||
| Address2: | CLOPTON CLINIC | ||||||||
| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724013104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709321198 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 CARSON ST | ||||||||
| Address2: | |||||||||
| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724013104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709321198 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2007 | ||||||||
| LastUpdateDate: | 06/08/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 054305 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | E-2507 | AR | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.