Provider Demographics
NPI:1881315919
Name:THIGPEN, LAWRENCE O III (HIS)
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:O
Last Name:THIGPEN
Suffix:III
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 FERNWOOD ST APT 621
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-4020
Mailing Address - Country:US
Mailing Address - Phone:804-536-1816
Mailing Address - Fax:
Practice Address - Street 1:1001 E LEIGH ST RM 14-015
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5004
Practice Address - Country:US
Practice Address - Phone:804-628-7923
Practice Address - Fax:804-807-7950
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101002612237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist