Provider Demographics
NPI:1013286822
Name:ESCHELMAN, LAWRENCE THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:THOMAS
Last Name:ESCHELMAN
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 1:3585 CHEROKEE DR S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-9712
Mailing Address - Country:US
Mailing Address - Phone:503-399-0710
Mailing Address - Fax:503-763-1591
Practice Address - Street 1:3585 CHEROKEE DR S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-9712
Practice Address - Country:US
Practice Address - Phone:503-399-0710
Practice Address - Fax:503-763-1591
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD07035207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology