Provider Demographics
NPI:1881357606
Name:MURRAY, LAWRENCE THEODORE II
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:THEODORE
Last Name:MURRAY
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2975 STARGAZE DR
Mailing Address - Street 2:
Mailing Address - City:DARDENNE PRAIRIE
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8069
Mailing Address - Country:US
Mailing Address - Phone:636-485-0168
Mailing Address - Fax:
Practice Address - Street 1:2000 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-5099
Practice Address - Country:US
Practice Address - Phone:563-589-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant