Basic Information
Provider Information
NPI: 1578585626
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAWRENCE
FirstName: MARK
MiddleName: E.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2187
Address2:  
City: SYLVA
State: NC
PostalCode: 287792187
CountryCode: US
TelephoneNumber: 8286313973
FaxNumber: 8286319280
Practice Location
Address1: 102 THOMAS HEIGHTS RD
Address2:  
City: FRANKLIN
State: NC
PostalCode: 287349799
CountryCode: US
TelephoneNumber: 8286313973
FaxNumber: 8286319280
Other Information
ProviderEnumerationDate: 07/24/2006
LastUpdateDate: 10/14/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X12241NCN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
2084P0800X28252NCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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