1851467716 NPI number — MR. DAVID LAWRENCE CARPENTER PA-C

Table of content: MR. DAVID LAWRENCE CARPENTER PA-C (NPI 1851467716)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851467716 NPI number — MR. DAVID LAWRENCE CARPENTER PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARPENTER
Provider First Name:
DAVID
Provider Middle Name:
LAWRENCE
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
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:
1851467716
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1365 CLINTON RD NE
Provider Second Line Business Mailing Address:
MASON TRANSPLANT CLINIC SUITE 6400
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30322-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-727-3599
Provider Business Mailing Address Fax Number:
404-727-8410

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1395 CLIFTON RD NE
Provider Second Line Business Practice Location Address:
SUITE 6400
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30322-1013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-727-3599
Provider Business Practice Location Address Fax Number:
404-727-8410
Provider Enumeration Date:
11/24/2006

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: 363A00000X , with the licence number:  005079 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363AM0700X , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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