1073523791 NPI number — CARL H LAWYER M.D.

Table of content: CARL H LAWYER M.D. (NPI 1073523791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073523791 NPI number — CARL H LAWYER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAWYER
Provider First Name:
CARL
Provider Middle Name:
H
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073523791
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/31/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1055 N 500 W
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PROVO
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84604-3305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-354-8225
Provider Business Mailing Address Fax Number:
801-429-8150

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 W 800 N
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
OREM
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84057-6301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-354-8205
Provider Business Practice Location Address Fax Number:
801-354-8206
Provider Enumeration Date:
08/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  036087801 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X , with the licence number: 036087801 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X , with the licence number: 2004030793 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X , with the licence number: 7484405-1205 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 020057300 . This is a "BLACK LUNG" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 036087801 . This is a "IL STATE LICENSE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 077831 . This is a "HEALTH ALLIANCE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 08421024 . This is a "BC/BS" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 290014322 . This is a "RR MEDICARE PIN" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 371363944 . This is a "IRS TAX ID" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 036087801 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 133586700 . This is a "ACS-OWCP" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 14D0949277 . This is a "CLIA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 468846 . This is a "HEALTHLINK" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 6394P . This is a "CATERPILLAR" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: CD7143 . This is a "RR MEDICARE GROUP#" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 170770 . This is a "PERSONAL CARE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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