Provider Demographics
NPI:1194827949
Name:LAWRENCE, JEFFREY DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DAVID
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4001 LAKE OTIS PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5200
Mailing Address - Country:US
Mailing Address - Phone:907-561-7757
Mailing Address - Fax:907-561-7767
Practice Address - Street 1:4001 LAKE OTIS PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5200
Practice Address - Country:US
Practice Address - Phone:907-561-7757
Practice Address - Fax:907-561-7767
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AKAA1970207VB0002X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VB0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObesity Medicine
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD19701Medicaid
AK160365Medicare PIN
C97152Medicare UPIN