LAKI LAMAR SYPH , NPI 1225595457 — PHOENIX (AZ)

NPI 1225595457

1+ Years Experience Individual

LAKI LAMAR SYPH

02/24/2019
PROVIDER ENUMERATION DATE
02/24/2019
LAST UPDATE DATE
1225595457
NPI NUMBER

About LAKI LAMAR SYPH

Sole proprietor? Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor.

LAKI LAMAR SYPH is a provider established in PHOENIX, AZ. The NPI number of LAKI LAMAR SYPH is 1225595457 and was assigned on 02/24/2019. The practitioners primary taxonomy code is: 246XS1301X .

Mailing address

  • City: AVONDALE
  • State: AZ
  • Postal code: 853925465
  • Phone: 4802524796
  • Address: 11002 W MONTE VISTA RD

Primary Practice Address

  • Region : PHOENIX, AZ
  • NPI : 1225595457
  • Phone : 6232959761
  • Postalcode : 850311719
  • Address : 5251 W CAMPBELL AVE STE 209

Provider taxonomy - Specialist/Technologist Cardiovascular

  • Taxonomy code: 246XS1301X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy group: 193400000X SINGLE SPECIALTY GROUP.

Contacts:

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  • LAKI LAMAR SYPH
  • Address : 5251 W CAMPBELL AVE STE 209
  • Region : PHOENIX, AZ
  • NPI : 1225595457
  • Phone : 6232959761
  • Postalcode : 850311719

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address5251 W CAMPBELL AVE STE 209
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NamePHOENIX
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameAZ
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code850311719
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6232959761
The telephone number associated with the location address of the provider being identified.
NPI1225595457
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1246XS1301X
Provider Enumeration Date02/24/2019
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated02/24/2019
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)LAKI LAMAR SYPH
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address11002 W MONTE VISTA RD
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameAVONDALE
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameAZ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code853925465
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number4802524796
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1246XS1301X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Specialist/Technologist Cardiovascular
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorY
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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