Healthcare Provider Details

I. General information

NPI: 1548767627
Provider Name (Legal Business Name): JEFFREY CHRISTOPHER LAWRENCE MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MORRIS ST
CHARLESTON WV
25301-1326
US

IV. Provider business mailing address

209 SOUTHERN WOODS DR
SOUTH CHARLESTON WV
25309-8692
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-5432
  • Fax:
Mailing address:
  • Phone: 504-256-0929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number33581
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number33581
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: