Healthcare Provider Details

I. General information

NPI: 1215198130
Provider Name (Legal Business Name): LAUREN THORINGTON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 10/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 S MAIN ST RADIOLOGY DEPARTMENT
FINDLAY OH
45840-1214
US

IV. Provider business mailing address

2055 NORMANDIE DR SUITE 108
MONTGOMERY AL
36111-2732
US

V. Phone/Fax

Practice location:
  • Phone: 630-334-3034
  • Fax:
Mailing address:
  • Phone: 334-269-6337
  • Fax: 334-834-0657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number03611116158
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number34010282
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberDO1363
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: