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General NPI Number Information
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NPI Number | 1013963388
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Entity Type | Organization
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Legal Business Name | LAWRENCE SURGERY ASSOCIATES, P.A.
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 1112 W 6TH ST SUITE 204
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City | LAWRENCE
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State | KS
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Zip | 66044-2215
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Country | US
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Telephone | 785-843-2010
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Fax | 785-843-1639
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Provider Business Mailing Address
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Address Line | 1112 W 6TH ST SUITE 204
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City | LAWRENCE
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State | KS
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Zip | 66044-2215
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Country | US
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Telephone | 785-843-2010
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Fax | 785-843-1639
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK A PRAERGER
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Credential | MD
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Telephone | 785-843-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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