Provider Demographics
NPI:1508877275
Name:HELTON, LAWRENCE F (DPM)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:F
Last Name:HELTON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:761 GOLF VIEW DR
Mailing Address - Street 2:STE A
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-9655
Mailing Address - Country:US
Mailing Address - Phone:541-779-5263
Mailing Address - Fax:541-779-0555
Practice Address - Street 1:761 GOLF VIEW DR
Practice Address - Street 2:STE A
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-9655
Practice Address - Country:US
Practice Address - Phone:541-779-5263
Practice Address - Fax:541-779-0555
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDP00090213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR086397Medicaid
T67710Medicare UPIN
OR086397Medicaid
0947730001Medicare NSC