8/20/2019 Lafayette Data

1/18

First Name Last Name Professional Title Gender

Martin F Abbert MD Male

Ryan D Loyd DO Male

Payton G Brown MD

David L Alexander DDS Male

Scott A Reef DDS Male

Harry D Shull r MD Male

Sue A Leu!ch"e MD Fe#ale

Maurice P Lord $i DDS Male

8/20/2019 Lafayette Data

2/18

Oce Name Address City

%&' ( )*th St + ),& Lafayette

Arnett $#a-in- %&' ( )*th St + ),) Lafayette

%&' ( )*th St + ),& Lafayette

Periodontal A!!ociate! %&' ( )*th St + .,. Lafayette

Periodontal A!!ociate! %&' ( )*th St + .,. Lafayette

/aba!h 0alley Alliance %&' ( )*th St + ),& Lafayette

%&' ( )*th St Lafayette

%&' ( )*th St + .,, Lafayette

8/20/2019 Lafayette Data

3/18

State ZIP Code ZIP Four County Metro Area Phone Numer

$( %12,% )3'* 4$PP56A(O5 71*'8 %%192.&2

$( %12,% )3'* 4$PP56A(O5 71*'8 %%393,,,

$( %12,% )3'* 4$PP56A(O5 71*'8 %%192.&2

$( %12,% )32. 4$PP56A(O5 71*'8 %%192.&2

$( %12,% )32. 4$PP56A(O5 71*'8 %%192.&2

$( %12,% )3'* 4$PP56A(O5 71*'8 %%*9*%,,

$( %12,% )32' 4$PP56A(O5 71*'8 %%192.&2

$( %12,% )32. 4$PP56A(O5 71*'8 %%19*3'3

8/20/2019 Lafayette Data

4/18

Fa! Numer Numer Of "m#loyees Sales $olume

. :',,;,,, 9 & Million

. :',,;,,, 9 & Million

. :',,;,,, 9 & Million

% :',,;,,, 9 & Million

% :',,;,,, 9 & Million

. :',,;,,, 9 & Million

. :',,;,,, 9 & Million

% :',,;,,, 9 & Million

8/20/2019 Lafayette Data

5/18

Primary SIC Code Primary SIC %escri#tion Sic

3,&&9,& Phy!ician! < Sur-eon!

3,&&9,& Phy!ician! < Sur-eon!

3,&&9,& Phy!ician! < Sur-eon!

3,)&9,& Denti!t!

3,)&9,& Denti!t!

3,&&9,& Phy!ician! < Sur-eon!

3,&&9,& Phy!ician! < Sur-eon!

3,)&9,& Denti!t!

8/20/2019 Lafayette Data

6/18

Sic %escri#tion Franchise Code

PS=6H$A4R=

PA$( MA(AG5M5(4

P5R$ODO(4$6S

P5R$ODO(4$6S

PS=6H$A4R=

(5>ROLOG=

G5(5RAL D5(4$S4R=

8/20/2019 Lafayette Data

7/18

Franchise S#ecialty %esc & Franchise S#ecialty %esc '

PS=6H$A4R=

PA$( MA(AG5M5(4 $(45R(AL M5D$6$(5

P5R$ODO(4$6S

P5R$ODO(4$6S

PS=6H$A4R=

(5>ROLOG= PS=6H$A4R=

G5(5RAL D5(4$S4R=

8/20/2019 Lafayette Data

8/18

Franchise S#ecialty %esc ( Franchise S#ecialty %esc )

O4H5R SP56$AL4$5S OS45OPA4H= 7D?O?8

8/20/2019 Lafayette Data

9/18

Franchise S#ecialty %esc * Franchise S#ecialty %esc + Ai Numer

%)13'%).2

*,),*,2&'

1&&*3'2'&

1,,&%1'.&

2*,%23%&3

%.%'2*332

%..21*),)

%)')***'1

8/20/2019 Lafayette Data

10/18

8/20/2019 Lafayette Data

11/18

Secondary S#ecialty Ty#e Of Practice

O

O

O

O

O

O

(eurolo-y O

O

8/20/2019 Lafayette Data

12/18

Oce Mana-er First Name Oce Mana-er Last Name

Gloria Royer

Dou- ac"!on

Gloria Royer

Gloria Royer

Gloria Royer

Gloria Royer

 ulie Ply

8/20/2019 Lafayette Data

13/18

.oard Certi/ed Fla- A-e 0ear Graduated

1) &21,

'& &22&

13 &2*%

1* &2**

8/20/2019 Lafayette Data

14/18

Medical School Prescri#tions Per 1ee2  

$( >niver!ity School Of Denti!try

$( >niver!ity School Of Denti!try

$( >niver!ity School Of Denti!try

8/20/2019 Lafayette Data

15/18

3os#ital Licensed in State & Licensed in State '

$(

$(

$(

$(

8/20/2019 Lafayette Data

16/18

Licensed in State ( Acce#ts Ne4 Patients

8/20/2019 Lafayette Data

17/18

Acce#ted 3ealth Plans Acce#ts Medicare

D5L4A D5(4AL; D5L4A D5(4AL PR5M$5R

A54(A; 6HO$65 PL>S POS $$; 6$G(A; GR5A4/5S4 H5AL4H6AR596$G(A PPO;5MBL5MH5AL4H; 5MBL5M H5AL4H; M5D$6A$D;M5D$6AR5; M5D$6AR5 M6R

8/20/2019 Lafayette Data

18/18

Acce#ts Medicaid