1164422952 NPI number — DR. JOHN P LAPURGA MD

Table of content: DR. JOHN P LAPURGA MD (NPI 1164422952)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164422952 NPI number — DR. JOHN P LAPURGA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAPURGA
Provider First Name:
JOHN
Provider Middle Name:
P
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1164422952
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 714813
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43271-4813
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-293-0247
Provider Business Mailing Address Fax Number:
937-293-0960

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 MEDICAL DRIVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
LIMA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-224-7586
Provider Business Practice Location Address Fax Number:
419-224-9769
Provider Enumeration Date:
07/22/2005

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: 207L00000X , with the licence number:  35068216 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2114714 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".