Provider Demographics
NPI: | 1285458919 |
---|---|
Name: | ATKINS, LAMAR DESHAWN (RCP) |
Entity type: | Individual |
Prefix: | |
First Name: | LAMAR |
Middle Name: | DESHAWN |
Last Name: | ATKINS |
Suffix: | |
Gender: | M |
Credentials: | RCP |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 4323 N 12TH ST STE 201 |
Mailing Address - Street 2: | |
Mailing Address - City: | PHOENIX |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85014-4527 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 602-857-2113 |
Mailing Address - Fax: | 602-364-3809 |
Practice Address - Street 1: | 4323 N 12TH ST STE 201 |
Practice Address - Street 2: | |
Practice Address - City: | PHOENIX |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85014-4527 |
Practice Address - Country: | US |
Practice Address - Phone: | 602-857-2113 |
Practice Address - Fax: | 602-364-3809 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2024-11-11 |
Last Update Date: | 2024-12-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AZ | 010507 | 2278E1000X, 2278G0305X, 2278H0200X, 2278S1500X, 2278P1004X, 2278P3900X, 2278G1100X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2278G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | General Care |
No | 2278E1000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Educational |
No | 2278G0305X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Geriatric Care |
No | 2278H0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Home Health |
No | 2278S1500X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | SNF/Subacute Care |
No | 2278P1004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Pulmonary Diagnostics |
No | 2278P3900X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Neonatal/Pediatrics |