Basic Information
Provider Information
NPI: 1063829216
EntityType: 2
ReplacementNPI:  
OrganizationName: LAWRENCE PHYSICIANS LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: LAWRENCE OB/GYN SPECIALISTS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 330 ARKANSAS ST
Address2: SUITE 300
City: LAWRENCE
State: KS
PostalCode: 660441335
CountryCode: US
TelephoneNumber: 7858321424
FaxNumber: 7855055240
Practice Location
Address1: 330 ARKANSAS ST
Address2: SUITE 300
City: LAWRENCE
State: KS
PostalCode: 660441335
CountryCode: US
TelephoneNumber: 7858321424
FaxNumber: 7855055240
Other Information
ProviderEnumerationDate: 07/21/2014
LastUpdateDate: 05/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MILLER
AuthorizedOfficialFirstName: AMY
AuthorizedOfficialMiddleName: C
AuthorizedOfficialTitleorPosition: CREDENTIALING SPEC
AuthorizedOfficialTelephone: 7855052988
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: CPC
NPICertificationDate: 05/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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