Provider Demographics
NPI:1467484428
Name:CARPENTER, LYNDON B (DC)
Entity Type:Individual
Prefix:DR
First Name:LYNDON
Middle Name:B
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 STERLINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:FARMERVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71241-3122
Mailing Address - Country:US
Mailing Address - Phone:318-368-9049
Mailing Address - Fax:318-368-9051
Practice Address - Street 1:509 STERLINGTON HWY
Practice Address - Street 2:
Practice Address - City:FARMERVILLE
Practice Address - State:LA
Practice Address - Zip Code:71241-3122
Practice Address - Country:US
Practice Address - Phone:318-368-9049
Practice Address - Fax:318-368-9051
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1183111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA721434608OtherSTATE GROUP BENEFITS
LA721454608OtherUNITED HEALTH CARE
LAP00073868OtherRAILROAD MEDICARE NUMBER
LA7345053OtherATENA
LAP00073868OtherRAILROAD MEDICARE NUMBER
LA721434608OtherSTATE GROUP BENEFITS