1669745303 NPI number — MR. CHRISTOPHER BYRON ARCEMENT NURSE PRACTITIONER(N

Table of content: MR. CHRISTOPHER BYRON ARCEMENT NURSE PRACTITIONER(N (NPI 1669745303)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669745303 NPI number — MR. CHRISTOPHER BYRON ARCEMENT NURSE PRACTITIONER(N

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARCEMENT
Provider First Name:
CHRISTOPHER
Provider Middle Name:
BYRON
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONER(N
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:
1669745303
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
149 DRINKWATER BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAY ST. LOUIS
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
228-467-8600
Provider Business Mailing Address Fax Number:
228-467-8799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5435 GEX RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DIAMONDHEAD
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39525
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
228-255-8216
Provider Business Practice Location Address Fax Number:
228-255-8219
Provider Enumeration Date:
02/10/2012

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: 363L00000X , with the licence number:  R859319 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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