Provider Demographics
NPI:1376283234
Name:LAWRENCE, SOPHIE W (MD)
Entity type:Individual
Prefix:
First Name:SOPHIE
Middle Name:W
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:222 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1852
Mailing Address - Country:US
Mailing Address - Phone:629-255-3486
Mailing Address - Fax:629-255-3075
Practice Address - Street 1:222 22ND AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1852
Practice Address - Country:US
Practice Address - Phone:629-255-2148
Practice Address - Fax:629-255-4108
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-30
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN72128207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ075508Medicaid