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NPI Code Detail

MEDICARE: LAWRENCE JAMES EGGER PA9108319

MEDICARE: LAWRENCE JAMES EGGER PA9108319
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA9108319FL
2363A00000XPhysician AssistantPA9108319FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407876949
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAWRENCE JAMES EGGER PA9108319
Provider Business Mailing Address
First Line : 1454 MADISON AVE W
Second Line :
City : IMMOKALEE
State : FL
Zip : 34142-2200
Country : US
Telephone Number : 239-658-3000
Fax Number :
Provider Business Practice Location Address
First Line : 2355 STANFORD CT
Second Line :
City : NAPLES
State : FL
Zip : 34112-4813
Country : US
Telephone Number : 239-658-3776
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 06/14/2024

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Directions to “ LAWRENCE JAMES EGGER PA9108319” Practice Location

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