Provider Demographics
NPI:1851396725
Name:LAWRENCE, CHRISTOPHER F (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:F
Last Name:LAWRENCE
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 1:4204 TEUTON ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-4164
Mailing Address - Country:US
Mailing Address - Phone:504-833-8111
Mailing Address - Fax:504-883-3555
Practice Address - Street 1:4204 TEUTON ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4164
Practice Address - Country:US
Practice Address - Phone:504-833-8111
Practice Address - Fax:504-883-3555
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0187902085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1917231Medicaid
LA1917231Medicaid
LA5N686Medicare PIN
E65011Medicare UPIN