Provider Demographics
NPI:1295731891
Name:LAMEY, CHARLES CLAYTON JR (DC)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:CLAYTON
Last Name:LAMEY
Suffix:JR
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:PO BOX 506
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72033-0506
Mailing Address - Country:US
Mailing Address - Phone:501-327-4484
Mailing Address - Fax:501-327-5963
Practice Address - Street 1:523 HARKRIDER ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-5631
Practice Address - Country:US
Practice Address - Phone:501-327-4484
Practice Address - Fax:501-327-5963
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR902111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR102212718Medicaid
T20663Medicare UPIN
AR59496Medicare ID - Type Unspecified