Provider Demographics
NPI:1427217611
Name:B. BROOKS LAWRENCE, M.D., P.A.
Entity Type:Organization
Organization Name:B. BROOKS LAWRENCE, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:B
Authorized Official - Middle Name:BROOKS
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-327-6900
Mailing Address - Street 1:PO BOX 10581
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-0009
Mailing Address - Country:US
Mailing Address - Phone:501-327-6900
Mailing Address - Fax:501-327-3690
Practice Address - Street 1:3650 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-7272
Practice Address - Country:US
Practice Address - Phone:501-327-6900
Practice Address - Fax:501-327-3690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC8006207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR16918000000OtherQUAL CHOICE
AR5K059OtherHEALTH ADVANTAGE
AR129592002Medicaid
AR432352883OtherNOVASYS
AR7464032OtherAETNA
AR392651OtherHEALTH LINK
AR0722160002OtherCIGNA
ARFP98253OtherUNITED HEALTHCARE
AR5K059OtherBCBS
ARFP98253OtherUNITED HEALTHCARE
AR0722160002OtherCIGNA
AR5K059OtherBCBS