Provider Demographics
NPI:1336197490
Name:LAWRENCE, RICHARD LLOYD JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LLOYD
Last Name:LAWRENCE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:939 BOB ARNOLD BLVD
Mailing Address - Street 2:SUITE G
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-3258
Mailing Address - Country:US
Mailing Address - Phone:678-945-3939
Mailing Address - Fax:678-945-3935
Practice Address - Street 1:939 BOB ARNOLD BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-3258
Practice Address - Country:US
Practice Address - Phone:678-945-3939
Practice Address - Fax:678-945-3935
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2008-05-15
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Provider Licenses
StateLicense IDTaxonomies
GA57389207W00000X
AL27365207W00000X
SC25403207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11552353OtherCAQH
1336197490OtherNPI INDIVIDUAL
GA11552353OtherCAQH