Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | E3446 | AR |
NPI | 1336100262 |
---|---|
Provider Name | Dr. Lawrence Curtis Bandy |
First Address | Little Rock, AR 72205-6321 |
Second Address | Little Rock, AR 72205-6321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2006 |
Last Update Date | 08/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
146951001 | (05) | AR |
5M299 | BCBS (01) | AR |
771050401 | BREAST CARE MEDICAID (01) | AR |
C82694 | (02) | |
P00069400 | RR MEDICARE (01) | AR |