Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 59219 | MA |
NPI | 1225003049 |
---|---|
Provider Name | Lawrence P Johnson |
First Address | North Chelmsford, MA 01863-2439 |
Second Address | North Chelmsford, MA 01863-2439 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 07/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0174289 | (05) | MA |
B97237 | (02) | MA |