Provider Demographics
NPI:1134161516
Name:LAWRENCE, WILLIAM HENRY (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HENRY
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:HENRY
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2119 E LAMAR RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-1147
Mailing Address - Country:US
Mailing Address - Phone:602-266-5095
Mailing Address - Fax:602-200-6021
Practice Address - Street 1:2119 E LAMAR RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-1147
Practice Address - Country:US
Practice Address - Phone:602-266-5095
Practice Address - Fax:602-200-6021
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG119502084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology