Provider Demographics
NPI:1326212440
Name:JOSEPH M LACAVA
Entity Type:Organization
Organization Name:JOSEPH M LACAVA
Other - Org Name:CENTRAL ARKANSAS FOOTCARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LACAVA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:501-321-4844
Mailing Address - Street 1:3339 CENTRAL AVE STE F
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6279
Mailing Address - Country:US
Mailing Address - Phone:501-321-4844
Mailing Address - Fax:501-321-0956
Practice Address - Street 1:3339 CENTRAL AVE STE F
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6279
Practice Address - Country:US
Practice Address - Phone:501-321-4844
Practice Address - Fax:501-321-0956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR217213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5369540001Medicare NSC