DR. JACK LAURENCE WAPNER


Address: 11100 Liberty Rd, Suite F, Randallstown, MD 21133-1026
Phone: 4106552740

DR. JACK LAURENCE WAPNER (NPI# 1164688677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164688677
Entity Type Individual
Full Name DR. JACK LAURENCE WAPNER
Credential M.D.
Practice Address 11100 Liberty Rd
Suite F
Randallstown
MD 21133-1026
Practice Telephone 4106552740
Practice Fax Number 4106554740
Mailing Telephone 4106552740
Mailing Fax Number 4106554740
Enumeration Date 2008-08-04
Last Update Date 2008-08-04
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084A0401X Psychiatry & Neurology
Specialization: Addiction Medicine
D0026048 MD Allopathic & Osteopathic Physicians

Office Location

Street Address 11100 LIBERTY RD
SUITE F
City RANDALLSTOWN
State MD
Zip Code 21133-1026

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1649898313 Olivia David Registered Nurse 3525 Liberty Resource Drive, Randallstown, MD 21133 2020-07-09
1366082547 Jerry Njomgert Christopher Home Health Aide 9106 Sandra Ct. Randallstown, Randallstown, MD 21133 2020-01-15
1487138913 For Hope's Sake, LLC Substance Abuse Rehabilitation Facility 9905 Southhall Road, Randallstown, MD 21133 2018-09-20
1295214393 Levindale Hebrew Geriatric Center & Hospital Inc Clinic/Center Lifebridge Health Adult Day Services, 5400 Old Court Road, Randallstown, MD 21133 2018-08-09
1235623968 Away of Change Counseling Service, LLC Counselor 5310 Old Court Rd Ste 304, Randallstown, MD 21133 2018-06-16
1922503382 Top Care Residential Inc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 8607 Liberty Rd, Randallstown, MD 21133 2018-03-28
1497274880 Yushika M Shepherd In Home Supportive Care 8911 Allenswood Rd, Randallstown, MD 21133 2017-09-17
1790208718 Productive Lives Mental Health, LLC Clinic/Center Randallstown Medical Center 5310 Old Court Rd Suite 308, Randallstown, MD 21133 2017-07-21
1982136198 Marla Rosanne Yee Dentist 5415 Old Court Road, Suite 01, Randallstown, MD 21133 2017-03-28
1598203549 Traci Harris Social Worker 9633 Liberty Rd. (suites H&j), Randallstown, MD 21133 2017-02-09
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Taxonomy Information

Taxonomy Code 2084A0401X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Addiction Medicine

Taxonomy Definition

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine
Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1689817447 First Step, Inc Psychiatry & Neurology 3525 Resource Dr, Randallstown, MD 21133-4733 2009-04-09

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1740631951 Carrie Schmitt Psychiatry & Neurology 8470 Dorsey Run Rd, Jessup, MD 20794-9486 2016-06-29
1871999276 Bergand Group Psychiatry & Neurology 1803 Harford Rd, Fallston, MD 21047 2014-11-12
1578876264 Belitehorizonmedicalcenter Psychiatry & Neurology 26825 Pointlook Out Road, Stee, Leonardtown, MD 20650 2010-07-22
1003018813 Donald Harry Taylor Psychiatry & Neurology 4545 Crain Hwy, Substance Abuse Services, White Plains, MD 20695-1050 2007-06-04
1649317264 Marc Judah Fishman Psychiatry & Neurology 3800 Frederick Avenue, Na, Baltimore, MD 21229-3618 2007-01-31
1831284769 Syed Asif H Ali Psychiatry & Neurology 13102 Autumn Dr, Silver Spring, MD 20904-3307 2006-10-04
1861599490 Rhonda Lynn Allen Psychiatry & Neurology 5401 Loch Raven Blvd Fl 2, Baltimore, MD 21239-2902 2006-09-17
1952404840 Samathanam N Abraham Psychiatry & Neurology 13207 Valley Dr, Rockville, MD 20850-3626 2006-09-06
1174634869 Indu Mago Sud Psychiatry & Neurology 17958 Pond Rd, Ashton, MD 20861-9756 2006-08-31
1619082005 Maryland Treatment Centers, Inc. Psychiatry & Neurology 14703 Avery Rd, Rockville, MD 20853-3605 2006-08-19
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Competitor

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City RANDALLSTOWN
Zip Code 21133

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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