Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | AA1970 | AK |
NPI | 1194827949 |
---|---|
Provider Name | Dr. Jeffrey David Lawrence |
First Address | Anchorage, AK 99508-5200 |
Second Address | Anchorage, AK 99508-5200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 14/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C97152 | (02) | |
MD19701 | (05) | AK |