Provider Demographics
NPI:1710903745
Name:LAWRENCE SCHOELKOPF MD PC
Entity Type:Organization
Organization Name:LAWRENCE SCHOELKOPF MD PC
Other - Org Name:LAWRENCE SCHOELKOPF MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOELKOPF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-867-5350
Mailing Address - Street 1:1000 LINCOLN ST
Mailing Address - Street 2:STE 208
Mailing Address - City:FORT MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701-3290
Mailing Address - Country:US
Mailing Address - Phone:970-867-5350
Mailing Address - Fax:970-867-3975
Practice Address - Street 1:1000 LINCOLN ST
Practice Address - Street 2:STE 208
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-3290
Practice Address - Country:US
Practice Address - Phone:970-867-5350
Practice Address - Fax:970-867-3975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32842208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO020051543OtherRAILROAD MEDICARE
CO01328426Medicaid
LA653342OtherANTHEM
CO020051543OtherRAILROAD MEDICARE
CO01328426Medicaid