Provider Demographics
NPI:1740561620
Name:BETTS, LAWRENCE STILWELL (MD PHD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:STILWELL
Last Name:BETTS
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2185
Mailing Address - Street 2:
Mailing Address - City:POQUOSON
Mailing Address - State:VA
Mailing Address - Zip Code:23662-0185
Mailing Address - Country:US
Mailing Address - Phone:757-373-1177
Mailing Address - Fax:
Practice Address - Street 1:13 DRYDEN DR
Practice Address - Street 2:
Practice Address - City:POQUOSON
Practice Address - State:VA
Practice Address - Zip Code:23662-1453
Practice Address - Country:US
Practice Address - Phone:757-373-1177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010548402083X0100X
CAG 0714662083X0100X
MN033 027 52083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine