Basic Information
| Provider Information | |||||||||
| NPI: | 1497868897 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHWARTZ | ||||||||
| FirstName: | LAURENCE | ||||||||
| MiddleName: | WILLIAMSON | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1003 E REELFOOT AVE | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | UNION CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 382615871 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7315999766 | ||||||||
| FaxNumber: | 7315999887 | ||||||||
| Practice Location | |||||||||
| Address1: | 6025 WALNUT GROVE RD STE 207 | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381202122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012260200 | ||||||||
| FaxNumber: | 9012260215 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2006 | ||||||||
| LastUpdateDate: | 08/27/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 1368 | TN | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0005X | 1368 | TN | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | T08583A | 01 | TN | MEDICARE | OTHER | 6186186 | 01 | TN | BCBS | OTHER | 1515921 | 05 | TN | MEDICAID |