Provider Demographics
NPI:1124055900
Name:CARPENTER, LAWRENCE JAY JR (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:JAY
Last Name:CARPENTER
Suffix:JR
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 1:3 MOBILE INFIRMARY CIR
Mailing Address - Street 2:STE 201
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3514
Mailing Address - Country:US
Mailing Address - Phone:251-435-7900
Mailing Address - Fax:251-435-6261
Practice Address - Street 1:3 MOBILE INFIRMARY CIR
Practice Address - Street 2:STE 201
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3514
Practice Address - Country:US
Practice Address - Phone:251-435-7900
Practice Address - Fax:251-435-6261
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21817174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0552570001OtherCIGNA
AL51516740OtherBLUE CROSS BLUE SHIELD
AL51516740Medicare ID - Type UnspecifiedMEDICARE
ALG70499Medicare UPIN
AL000016740Medicare PIN