1578991527 NPI number — MR. LAWRENCE GERALD WHITTINGTON

Table of content: MR. LAWRENCE GERALD WHITTINGTON (NPI 1578991527)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578991527 NPI number — MR. LAWRENCE GERALD WHITTINGTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITTINGTON
Provider First Name:
LAWRENCE
Provider Middle Name:
GERALD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WHITTINGTON
Provider Other First Name:
JANICE
Provider Other Middle Name:
MAUREEN
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1578991527
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/29/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
724 S. CENTRAL SUITE 101
Provider Second Line Business Mailing Address:
FAMILY SOLUTIONS
Provider Business Mailing Address City Name:
MEDFORD
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-776-5793
Provider Business Mailing Address Fax Number:
541-776-5798

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6340 HONEY TREE LN.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CENTRAL POINT
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-664-3297
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/29/2013

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: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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