=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922010958
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES THOMAS SALMON M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 135 EAST 38TH ST ERIE VA MEDICAL CENTER
-----------------------------------------------------
City | ERIE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16504
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-860-2654
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5048 WESTBURY FARMS DR
-----------------------------------------------------
City | ERIE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16506-6120
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-860-2654
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | MD-070568
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------