Withers, Larry Dale
Withers, Larry Dale is an individual health care provider with primary practice located at 1638 Owen Dr , Fayetteville NC 28304-3424. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Withers, Larry Dale can be contacted via phone (910) 323-8594.Contact Information
Primary practice address
1638 Owen Dr
Fayetteville NC 28304-3424
Phone: (910) 323-8594
Fax: (910) 323-5795
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 24316 | North Carolina |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 24316 | North Carolina |
Profile Details
| NPI number | 1043311301 |
|---|---|
| LBN Legal business name | Withers, Larry Dale |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2006 |
| Last updated | Oct 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043311301 | NPPES |
| North Carolina | MEDICAID | 8988664 | |
| North Carolina | Other | 50011540 | |
| North Carolina | Other | 88664 | |
| North Carolina | Other | 88664 |
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