Lase Med, Inc.

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

3803 Issued in OK

Legal business name

LASE MED, INC.

Practice address

500 N Poplar Ave
Ste a
Broken Arrow, OK 74012-2337

Phone

(918) 398-9577

Fax

(918) 398-4488

NPI assigned

Jul 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Antonella Carpenter, PHD

Title

Ceo

Phone

(702) 953-0267

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1710186994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1894 US HIGHWAY 50 E",
            "address_2": "STE 4 #160",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897013244",
            "telephone_number": "702-953-0267",
            "fax_number": "702-967-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N POPLAR AVE",
            "address_2": "STE A",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740122337",
            "telephone_number": "918-398-9577",
            "fax_number": "918-398-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASE MED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "ANTONELLA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-953-0267",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "OK",
            "license": "3803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Point of Service in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.