Provider Demographics
NPI:1235130543
Name:TARPLEY, LORENZO JR (PA-C)
Entity Type:Individual
Prefix:
First Name:LORENZO
Middle Name:
Last Name:TARPLEY
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 ROLLINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22406-7268
Mailing Address - Country:US
Mailing Address - Phone:540-752-9517
Mailing Address - Fax:540-752-9589
Practice Address - Street 1:2300 E STREET NW
Practice Address - Street 2:BUREAU OF MEDICINE AND SURGERY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20374-5300
Practice Address - Country:US
Practice Address - Phone:202-762-0174
Practice Address - Fax:202-762-3470
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14666363AM0700X
IL363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical