Basic Information
| Provider Information | |||||||||
| NPI: | 1730401944 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LOU MAUNEY DO INC | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 10484 STRINGFELLOW RD | ||||||||
| Address2: | |||||||||
| City: | ST JAMES CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339563208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2392835200 | ||||||||
| FaxNumber: | 2392837620 | ||||||||
| Practice Location | |||||||||
| Address1: | 10484 STRINGFELLOW RD | ||||||||
| Address2: | |||||||||
| City: | ST JAMES CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339563208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2392835200 | ||||||||
| FaxNumber: | 2392837620 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2010 | ||||||||
| LastUpdateDate: | 02/16/2010 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | MAUNEY | ||||||||
| AuthorizedOfficialFirstName: | LOU | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2392835200 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.