1467484428 NPI number — DR. LYNDON B CARPENTER D.C.

Table of content: DR. LYNDON B CARPENTER D.C. (NPI 1467484428)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467484428 NPI number — DR. LYNDON B CARPENTER D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARPENTER
Provider First Name:
LYNDON
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.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:
1467484428
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:
509 STERLINGTON HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMERVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71241-3122
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-368-9049
Provider Business Mailing Address Fax Number:
318-368-9051

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
509 STERLINGTON HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARMERVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71241-3122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-368-9049
Provider Business Practice Location Address Fax Number:
318-368-9051
Provider Enumeration Date:
07/07/2006

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: 111N00000X , with the licence number:  1183 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 721434608 . This is a "STATE GROUP BENEFITS" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 721454608 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: P00073868 . This is a "RAILROAD MEDICARE NUMBER" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 7345053 . This is a "ATENA" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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