Healthcare Provider Details

I. General information

NPI: 1508273756
Provider Name (Legal Business Name): LAWRENCE PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2014
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 S UNION ST
MC LOUTH KS
66054-4103
US

IV. Provider business mailing address

313 S UNION ST
MC LOUTH KS
66054-4103
US

V. Phone/Fax

Practice location:
  • Phone: 913-796-6116
  • Fax: 913-796-2222
Mailing address:
  • Phone: 913-796-6116
  • Fax: 785-505-5274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: HEATHER BAHNMAIER
Title or Position: INSURANCE CREDENTIALING SPECIALIST
Credential:
Phone: 785-505-2988