Basic Information
| Provider Information | |||||||||
| NPI: | 1811929557 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAWRENCE | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1860 US HIGHWAY 43 | ||||||||
| Address2: | |||||||||
| City: | WINFIELD | ||||||||
| State: | AL | ||||||||
| PostalCode: | 355945062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2054871111 | ||||||||
| FaxNumber: | 2054871114 | ||||||||
| Practice Location | |||||||||
| Address1: | 15243 GREENFIELD DR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | ATHENS | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356132899 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2562332332 | ||||||||
| FaxNumber: | 2562163579 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 09/19/2012 | ||||||||
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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 | 19174 | MS | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | DO.1220 | AL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.