Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | POD000831 | GA |
Y | 222Z00000X | Podiatrist | POD000831 | GA |
NPI | 1013006618 |
---|---|
Provider Name | Stephan J Lapointe |
First Address | Rome, GA 30165-2640 |
Second Address | Rome, GA 30165-1612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 01/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00955721D | (05) | GA |
00955721G | (05) | GA |
U76491 | (02) | GA |