1508201195 NPI number — LAUREN EDWARDS MCCASLIN M.D.

Table of content: LAUREN EDWARDS MCCASLIN M.D. (NPI 1508201195)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508201195 NPI number — LAUREN EDWARDS MCCASLIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCASLIN
Provider First Name:
LAUREN
Provider Middle Name:
EDWARDS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1508201195
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/04/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3215 NORTH NORTHHILLS BOULEVARD
Provider Second Line Business Mailing Address:
WASHINGTON REGIONAL MEDICAL CENTER
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
479-463-1000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 ROSE ST
Provider Second Line Business Practice Location Address:
UNIVERSITY OF KENTUCKY
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40536-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-323-2300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/08/2013

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: 207P00000X , with the licence number:  E9726 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: E9726 . This is a "ARKANSAS STATE MEDICAL BOARD" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: R3385 . This is a "EMERGENCY MEDICINE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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