Provider Demographics
NPI:1639208960
Name:LAWRENCE, CARL ANDREW
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:ANDREW
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 DENHAM AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4425
Mailing Address - Country:US
Mailing Address - Phone:931-490-4346
Mailing Address - Fax:
Practice Address - Street 1:1222 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-6402
Practice Address - Country:US
Practice Address - Phone:931-490-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist