Provider Demographics
NPI:1457364556
Name:PIMPERL, L. CAMERON (MD)
Entity Type:Individual
Prefix:DR
First Name:L.
Middle Name:CAMERON
Last Name:PIMPERL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 S 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39440-4111
Mailing Address - Country:US
Mailing Address - Phone:601-425-2999
Mailing Address - Fax:601-425-3286
Practice Address - Street 1:127 S 13TH AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-4111
Practice Address - Country:US
Practice Address - Phone:601-425-2999
Practice Address - Fax:601-425-3286
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS190542085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS19054OtherMISSISSIPPI MEDICAL LICEN
MS302I922979OtherPIMPRELL MEDICARE PTAN EFFECTIVE 05/19/2012
MS302G702986OtherONCOLOGICS LLC GROUP PTAN
MS04150773Medicaid
MS302G702986OtherONCOLOGICS LLC GROUP PTAN
I43078Medicare UPIN