Healthcare Provider Details

I. General information

NPI: 1538278940
Provider Name (Legal Business Name): LAWRENCE C. LAYMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 CHAFEE AVE
AUGUSTA GA
30904-5806
US

IV. Provider business mailing address

1499 WALTON WAY STE 1400
AUGUSTA GA
30901-2602
US

V. Phone/Fax

Practice location:
  • Phone: 706-722-4434
  • Fax: 706-722-9469
Mailing address:
  • Phone: 706-828-8402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number028589
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: