Lawrence, Larry Douglas
Lawrence, Larry Douglas is an individual health care provider with primary practice located at 1111 Crater Lake Ave , Medford OR 97504-6241. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Lawrence, Larry Douglas can be contacted via phone (541) 732-5545.Contact Information
Primary practice address
1111 Crater Lake Ave
Medford OR 97504-6241
Phone: (541) 732-5545
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 2007-00008 | North Carolina |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | TD171105 | Maine |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | MD184500 | Oregon |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 2007-00008 | North Carolina |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD22370 | Maine |
Profile Details
| NPI number | 1235261827 |
|---|---|
| LBN Legal business name | Lawrence, Larry Douglas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 10th, 2007 |
| Last updated | Jul 22nd, 2021 - 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 | 1235261827 | NPPES |
| North Carolina | Other | 145CN | BCBSNC |
| North Carolina | MEDICAID | 5907104 | BCBSNC |
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