Provider Demographics
NPI:1134498108
Name:LAKE NORMAN ARTHRITIS SPECIALISTS, PA
Entity Type:Organization
Organization Name:LAKE NORMAN ARTHRITIS SPECIALISTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-895-5110
Mailing Address - Street 1:130 HARBOUR PLACE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-7441
Mailing Address - Country:US
Mailing Address - Phone:704-895-5110
Mailing Address - Fax:704-895-7115
Practice Address - Street 1:130 HARBOUR PLACE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-7441
Practice Address - Country:US
Practice Address - Phone:704-895-5110
Practice Address - Fax:704-895-7115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty