Provider Demographics
NPI:1487989364
Name:SHANNON, LAMAR F (MBA/HCM)
Entity type:Individual
Prefix:
First Name:LAMAR
Middle Name:F
Last Name:SHANNON
Suffix:
Gender:M
Credentials:MBA/HCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 586
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:NC
Mailing Address - Zip Code:28398-0586
Mailing Address - Country:US
Mailing Address - Phone:910-293-4919
Mailing Address - Fax:910-293-4533
Practice Address - Street 1:206 N FRONT ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NC
Practice Address - Zip Code:28398-1833
Practice Address - Country:US
Practice Address - Phone:910-293-4919
Practice Address - Fax:910-293-4533
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No172V00000XOther Service ProvidersCommunity Health Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program