Basic Information
Provider Information | |||||||||
NPI: | 1760464044 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SINDEL | ||||||||
FirstName: | LAWRENCE | ||||||||
MiddleName: | JAMES | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 7987 | ||||||||
Address2: |   | ||||||||
City: | MOBILE | ||||||||
State: | AL | ||||||||
PostalCode: | 366700987 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2516330573 | ||||||||
FaxNumber: | 2516337367 | ||||||||
Practice Location | |||||||||
Address1: | 100 MEMORIAL HOSPITAL DR STE 1A | ||||||||
Address2: |   | ||||||||
City: | MOBILE | ||||||||
State: | AL | ||||||||
PostalCode: | 36608 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2513436848 | ||||||||
FaxNumber: | 2513435708 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/14/2005 | ||||||||
LastUpdateDate: | 06/28/2019 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0214X | 11173 | AL | N |   | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Pulmonology | 207K00000X | 11173 | AL | Y |   | Allopathic & Osteopathic Physicians | Allergy & Immunology |   |
ID Information
ID | Type | State | Issuer | Description | 209949 | 05 | AL |   | MEDICAID | 512-03771 | 01 | AL | BCBS | OTHER | 83766 | 05 | AL |   | MEDICAID | 0000833766 | 01 | AL | MEDICARE | OTHER | 213239 | 05 | AL |   | MEDICAID | 4681226 | 01 | AL | CIGNA HC | OTHER | 214043 | 05 | AL |   | MEDICAID | 1198800 | 01 | AL | UHC | OTHER | 208883 | 05 | AL |   | MEDICAID | 512-05848 | 01 | AL | BCBS | OTHER | 00115983 | 01 | MS | MS MEDICAID | OTHER | 30001919 | 01 | AL | RR MEDICARE | OTHER | 512-05849 | 01 | AL | BCBS | OTHER | 210336 | 05 | AL |   | MEDICAID | 4197911 | 01 | AL | AETNA | OTHER | 511-54509 | 01 | AL | BCBS | OTHER | C76860 | 01 | AL | VIVA HEALTH | OTHER |