Provider Demographics
NPI:1326899808
Name:LAWRENCE, CASEY ROBERT (PA)
Entity Type:Individual
Prefix:MR
First Name:CASEY
Middle Name:ROBERT
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:2061 EXPERIMENT STATION RD STE 505
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-5327
Mailing Address - Country:US
Mailing Address - Phone:706-310-0324
Mailing Address - Fax:706-310-0320
Practice Address - Street 1:2061 EXPERIMENT STATION RD STE 505
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-5327
Practice Address - Country:US
Practice Address - Phone:706-310-0324
Practice Address - Fax:706-310-0320
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant