Healthcare Provider Details

I. General information

NPI: 1326962440
Provider Name (Legal Business Name): LAWRENCE CALVIN STAPLES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 S 5TH ST
COLUMBUS OH
43215-5203
US

IV. Provider business mailing address

3833 BEIDLER PL
CANAL WINCHESTER OH
43110-1514
US

V. Phone/Fax

Practice location:
  • Phone: 614-567-6274
  • Fax: 855-604-0927
Mailing address:
  • Phone: 614-669-5390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number008226
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: