Healthcare Provider Details

I. General information

NPI: 1295803484
Provider Name (Legal Business Name): LAWRENCE CHARLES HILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 10/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4864 JACKSON ST
MONROE LA
71202-6400
US

IV. Provider business mailing address

2006 CARTER ST
WEST MONROE LA
71291-7602
US

V. Phone/Fax

Practice location:
  • Phone: 318-330-7626
  • Fax: 318-330-7648
Mailing address:
  • Phone: 318-397-2019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD013613
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number013613
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: