Provider Demographics
NPI:1477609485
Name:SCHIFF, LAURENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:
Last Name:SCHIFF
Suffix:
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:PO BOX 617
Mailing Address - Street 2:
Mailing Address - City:SOMERTON
Mailing Address - State:AZ
Mailing Address - Zip Code:85350-0617
Mailing Address - Country:US
Mailing Address - Phone:928-315-7910
Mailing Address - Fax:928-627-1255
Practice Address - Street 1:3931 STOCKTON HILL RD
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-3001
Practice Address - Country:US
Practice Address - Phone:928-681-2121
Practice Address - Fax:928-681-2000
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ291012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0891490OtherBCBS PROVIDER ID
AZ567612Medicaid
AZ567612Medicaid
AZ66524Medicare PIN