Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 0101253237 | VA |
Y | 207RP1001X | Pulmonary Disease | 0101253237 | VA |
NPI | 1063513489 |
---|---|
Provider Name | Kevin L Lawrence |
First Address | Fishersville, VA 22939-0388 |
Second Address | Fishersville, VA 22939-2273 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 26/12/2019 |