Basic Information
Provider Information
NPI: 1437248457
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SETTLE
FirstName: EDMUND
MiddleName: CARR
NamePrefix: DR.
NameSuffix: JR.
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1324 LAKELAND HILLS BLVD
Address2: ATTN MEDICAL STAFF OFFICE
City: LAKELAND
State: FL
PostalCode: 338054543
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 500 S FLORIDA AVE STE 210
Address2:  
City: LAKELAND
State: FL
PostalCode: 338015252
CountryCode: US
TelephoneNumber: 8636871222
FaxNumber: 8636036546
Other Information
ProviderEnumerationDate: 10/11/2006
LastUpdateDate: 07/29/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XME33032FLY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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