Provider Demographics
NPI:1942728365
Name:LAWRENCE S. WILNER, P.C.
Entity Type:Organization
Organization Name:LAWRENCE S. WILNER, P.C.
Other - Org Name:CASTLE PINES FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-814-0505
Mailing Address - Street 1:7280 LAGAE RD STE J
Mailing Address - Street 2:
Mailing Address - City:CASTLE PINES
Mailing Address - State:CO
Mailing Address - Zip Code:80108-9454
Mailing Address - Country:US
Mailing Address - Phone:303-814-0505
Mailing Address - Fax:303-914-6491
Practice Address - Street 1:7280 LAGAE RD STE J
Practice Address - Street 2:
Practice Address - City:CASTLE PINES
Practice Address - State:CO
Practice Address - Zip Code:80108-9454
Practice Address - Country:US
Practice Address - Phone:303-814-0505
Practice Address - Fax:303-914-6491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0032016207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty