Provider Demographics
NPI:1043821325
Name:LAWRENCE COUNTY MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:LAWRENCE COUNTY MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SHOBER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-658-7550
Mailing Address - Street 1:2520 WILMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1644
Mailing Address - Country:US
Mailing Address - Phone:724-658-7550
Mailing Address - Fax:724-658-7551
Practice Address - Street 1:2520 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1644
Practice Address - Country:US
Practice Address - Phone:724-658-7550
Practice Address - Fax:724-658-7551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty