Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 18299 | MS |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 301311 | LA |
NPI | 1962441352 |
---|---|
Provider Name | Dr. Lawrence Lee Haber |
First Address | New Orleans, LA 70121-2429 |
Second Address | Jackson, MS 39216-5114 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 19/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01252229 | (05) | MS |
512I200001 | UP MEDICARE PTAN (01) | MS |
G-60217 | (02) | MS |