Humphrey, Landon D

Humphrey, Landon D is an individual health care provider with primary practice located at 1500 Museum Rd , Conway AR 72032-4785. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Humphrey, Landon D can be contacted via phone (501) 932-9010.

Contact Information

Primary practice address
1500 Museum Rd Conway AR 72032-4785
Phone: (501) 932-9010
Fax: (501) 932-0020
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X E-9315 Arkansas

Profile Details

NPI number 1649447806
LBN Legal business name Humphrey, Landon D
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2008
Last updated Dec 6th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649447806 NPPES
Louisiana MEDICAID 05834
Louisiana MEDICAID 210943001

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