Provider Demographics
NPI:1952360307
Name:MCCHESNEY, LAWRENCE PAUL (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:PAUL
Last Name:MCCHESNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6907 SW HIGHWAY 200
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-9210
Mailing Address - Country:US
Mailing Address - Phone:352-300-3636
Mailing Address - Fax:352-624-8722
Practice Address - Street 1:6907 SW HIGHWAY 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-9210
Practice Address - Country:US
Practice Address - Phone:352-300-3636
Practice Address - Fax:352-624-8722
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT043891208600000X, 2086S0102X
IA36943208600000X, 204F00000X, 2086S0102X
FLME105261208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL146ELOtherBCBSFL
OH2126434Medicaid
IA0731299Medicaid
IA25373OtherWELLMARK BCBS
FL146ELOtherBCBSFL
OHMC0879941Medicare ID - Type Unspecified
FLCF431ZMedicare PIN
IAP00360478Medicare PIN
IA0731299Medicaid