Provider Demographics
NPI:1437163938
Name:STINSON, LAWRENCE W JR (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:W
Last Name:STINSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 ABBOTT RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-3448
Mailing Address - Country:US
Mailing Address - Phone:907-278-2741
Mailing Address - Fax:907-742-8284
Practice Address - Street 1:1917 ABBOTT RD
Practice Address - Street 2:STE 100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507
Practice Address - Country:US
Practice Address - Phone:907-278-2741
Practice Address - Fax:907-742-8284
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAK2119207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD21191Medicaid
AK151583Medicare ID - Type Unspecified
AKMD21191Medicaid