Basic Information
Provider Information
NPI: 1962476440
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOVEALL
FirstName: HAROLD
MiddleName: P
NamePrefix: DR.
NameSuffix: JR.
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2723 S 7TH ST
Address2: SUITE A
City: TERRE HAUTE
State: IN
PostalCode: 478023558
CountryCode: US
TelephoneNumber: 8122381730
FaxNumber: 8122421565
Practice Location
Address1: 2723 S 7TH STREET
Address2: SUITE C
City: TERRE HAUTE
State: IN
PostalCode: 478023558
CountryCode: US
TelephoneNumber: 8122325936
FaxNumber: 8122351290
Other Information
ProviderEnumerationDate: 02/14/2006
LastUpdateDate: 03/07/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X01025679AINY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
10025046005IN MEDICAID
08015101501INRAILROAD MEDICAREOTHER
00000009382101INANTHEMOTHER


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