Healthcare Provider Details

I. General information

NPI: 1205823549
Provider Name (Legal Business Name): ARTHUR NEW LAWRANCE JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 5142 BOX 18TH
APO AP
96368-5142
US

IV. Provider business mailing address

PO BOX 911416
DENVER CO
80291-1416
US

V. Phone/Fax

Practice location:
  • Phone: 315-630-0151
  • Fax:
Mailing address:
  • Phone: 970-547-9200
  • Fax: 970-262-2196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS9027
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0051205
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: