Conway, Lars T
Conway, Lars T is an sole proprietor health care provider with primary practice located at 625 E Broadway Ave , Jackson WY 83001-8642. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cytopathology, Allopathic & Osteopathic Physicians / Anatomic Pathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology is his primary health care specialty. Conway, Lars T can be contacted via phone (307) 733-6418.Contact Information
Primary practice address
625 E Broadway Ave
Jackson WY 83001-8642
Phone: (307) 733-6418
Fax: (307) 734-0885
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cytopathology | 207ZC0500X | 27443 | Minnesota |
| Allopathic & Osteopathic Physicians / Anatomic Pathology | 207ZP0101X | 27443 | Minnesota |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | M-12068 | Idaho |
| Allopathic & Osteopathic Physicians / Anatomic Pathology | 207ZP0101X | 9164A | Wyoming |
Profile Details
| NPI number | 1679534432 |
|---|---|
| LBN Legal business name | Conway, Lars T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 31st, 2006 |
| Last updated | Nov 20th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679534432 | NPPES |
| Minnesota | Other | 220007425 | RR MEDICARE |
| Minnesota | MEDICAID | 936780200 | RR MEDICARE |
| Minnesota | Other | 03069C0 | RR MEDICARE |
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