Provider Demographics
NPI:1174584023
Name:LABOUNTY, CHRIS R (MD)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:R
Last Name:LABOUNTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 PROSPECT AVE
Mailing Address - Street 2:MEDICAL EDUCATION
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1807
Mailing Address - Country:US
Mailing Address - Phone:315-448-5547
Mailing Address - Fax:315-448-6313
Practice Address - Street 1:301 PROSPECT AVE
Practice Address - Street 2:MEDICAL EDUCATION
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1807
Practice Address - Country:US
Practice Address - Phone:315-448-5547
Practice Address - Fax:315-448-6313
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1619981208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01124538Medicaid
P00114342Medicare PIN
B29471Medicare UPIN
NY01124538Medicaid