1831144344 NPI number — DR. DENISE FREE LENSGRAF-LANDERS AU.D.

Table of content: DR. DENISE FREE LENSGRAF-LANDERS AU.D. (NPI 1831144344)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831144344 NPI number — DR. DENISE FREE LENSGRAF-LANDERS AU.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LENSGRAF-LANDERS
Provider First Name:
DENISE
Provider Middle Name:
FREE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AU.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LENSGRAF
Provider Other First Name:
DENISE
Provider Other Middle Name:
FREE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
AU.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1831144344
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
609 SCOTTWOODS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUBURN
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36830-5219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-725-3060
Provider Business Mailing Address Fax Number:
334-725-3226

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CAVHCS AUDIOLOGY (117)
Provider Second Line Business Practice Location Address:
2400 HOSPITAL ROAD
Provider Business Practice Location Address City Name:
TUSKEGEE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36083
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-725-3060
Provider Business Practice Location Address Fax Number:
334-725-3226
Provider Enumeration Date:
05/23/2006

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: 231H00000X , with the licence number:  980A , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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