Provider Demographics
NPI:1174630008
Name:LAWRENCE M. STALLINGS, MD, LTD
Entity Type:Organization
Organization Name:LAWRENCE M. STALLINGS, MD, LTD
Other - Org Name:TRILOGY CANCER CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:STALLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-262-2800
Mailing Address - Street 1:2326A EAGLE PASS
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-5338
Mailing Address - Country:US
Mailing Address - Phone:330-262-2800
Mailing Address - Fax:330-262-2807
Practice Address - Street 1:2326A EAGLE PASS
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-5338
Practice Address - Country:US
Practice Address - Phone:330-262-2800
Practice Address - Fax:330-262-2807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2314552Medicaid
OHLA9303814Medicare ID - Type Unspecified