1710910005 NPI number — LAWRENCE S HOTES M.D.

Table of content: LAWRENCE S HOTES M.D. (NPI 1710910005)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710910005 NPI number — LAWRENCE S HOTES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOTES
Provider First Name:
LAWRENCE
Provider Middle Name:
S
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1710910005
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/23/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
150 YORK ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STOUGHTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02072-1829
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-297-1146
Provider Business Mailing Address Fax Number:
781-297-1575

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 YORK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STOUGHTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02072-1829
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-297-1146
Provider Business Practice Location Address Fax Number:
781-297-1575
Provider Enumeration Date:
07/09/2006

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: 207R00000X , with the licence number:  43798 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0103012 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com