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General NPI Number Information
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NPI Number | 1033304126
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Entity Type | Organization
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Legal Business Name | LAURENCE M SHARP DO PC
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 10/04/2011
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Provider Practice Location Address
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Address Line | 1813 W HARVARD AVE SUITE 426
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City | ROSEBURG
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State | OR
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Zip | 97471-2752
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Country | US
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Telephone | 541-459-1611
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Fax | 541-459-5741
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Provider Business Mailing Address
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Address Line | 1813 W HARVARD AVE SUITE 426
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City | ROSEBURG
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State | OR
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Zip | 97471-2752
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Country | US
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Telephone | 541-459-1611
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Fax | 541-459-5741
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAURENCE M SHARP
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Credential | DO
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Telephone | 541-459-1611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO15192
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License Number State | OR
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