Provider Demographics
NPI:1982685780
Name:SCHULL, LAWRENCE G JR (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:G
Last Name:SCHULL
Suffix:JR
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 1:2240 WOODRIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-1807
Mailing Address - Country:US
Mailing Address - Phone:931-933-1104
Mailing Address - Fax:
Practice Address - Street 1:2240 WOODRIDGE TRL
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-1807
Practice Address - Country:US
Practice Address - Phone:931-933-1104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD38767207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4091126OtherBCBS
TN3898318Medicaid
A47941Medicare UPIN
TN3848318Medicare ID - Type Unspecified