Provider Demographics
NPI:1528179207
Name:MCHENRY, LAWRENCE MARKHAM (DO)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:MARKHAM
Last Name:MCHENRY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9821 N 95TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4589
Mailing Address - Country:US
Mailing Address - Phone:480-525-5775
Mailing Address - Fax:480-525-5776
Practice Address - Street 1:9821 N 95TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4589
Practice Address - Country:US
Practice Address - Phone:480-525-5775
Practice Address - Fax:480-525-5776
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ3128207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ104882Medicare PIN
AZP00262340Medicare PIN
G43666Medicare UPIN