Lainey Medine Petty in Eglin Afb - Physician Assistant
Lainey Medine Petty - NPI 1053577213
Lainey Medine Petty is a Physician Assistant in Eglin Afb, Florida. Lainey Medine Petty practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Lainey Medine Petty is 1053577213. The last update date is 2020-06-22.
Lainey Medine Petty's current location address is 307 Boatner Rd Ste 114, Eglin Afb, Florida. You can contact this provider via phone number 8508838600. The mailing address for Lainey Medine Petty is 307 Boatner Rd Ste 114, Eglin Afb, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Lainey Medine Petty |
|---|---|
| Address | 307 Boatner Rd Ste 114, Eglin Afb, Florida |
| Phone Number | 8508838600 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1053577213 |
|---|---|
| Provider Enumeration Date | 2008-08-06 |
| Last Updated Date | 2020-06-22 |
Provider Mailing Address Detail
| Address | 307 Boatner Rd Ste 114 |
|---|---|
| City | Eglin Afb |
| State | Florida (FL) |
| Post Code | 325421302 |
| Phone Number | 8508838600 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA.2002.39RX |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1357103 | LA | -- |
Post Comment/ Review Below
What is the Lainey Medine Petty's 1053577213?
The Lainey Medine Petty's NPI (National Provider Identifier) Number is 1053577213. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Lainey Medine Petty's physical address?
The Lainey Medine Petty is physically located at 307 Boatner Rd Ste 114, in the city of Eglin Afb, FL, with the postal code 325421302.
What is the area of specialization for Lainey Medine Petty, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Lainey Medine Petty is Physician Assistant, and the corresponding taxonomy code that categorizes this area of expertise is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1053577213 to Lainey Medine Petty?
The Lainey Medine Petty received its 1053577213 assignment from the Centers for Medicare & Medicaid Services on 2008-08-06.
As of what date were the details pertaining to Lainey Medine Petty last refreshed?
The information related to the Lainey Medine Petty, including its address, specialty, and other relevant details, was last updated on 2020-06-22.