Provider Demographics
NPI:1659746535
Name:LMD PATH, INC
Entity Type:Organization
Organization Name:LMD PATH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:844-987-2267
Mailing Address - Street 1:PO BOX 143
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84603-0143
Mailing Address - Country:US
Mailing Address - Phone:844-987-2267
Mailing Address - Fax:844-266-9834
Practice Address - Street 1:1018 S 350 E
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-6152
Practice Address - Country:US
Practice Address - Phone:844-987-2267
Practice Address - Fax:844-266-9834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT52983651205207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty