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General NPI Number Information
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NPI Number | 1245435429
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Entity Type | Individual
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Provider Name | LAWRENCE LEE ROBINSON JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 11/10/2014
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Provider Practice Location Address
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Address Line | 80A INTERSTATE SOUTH DR
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City | JASPER
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State | GA
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Zip | 30143-6226
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Country | US
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Telephone | 770-345-6600
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Fax | 770-345-6611
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Provider Business Mailing Address
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Address Line | 215 RIVERSTONE DR
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City | CANTON
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State | GA
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Zip | 30114-5256
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Country | US
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Telephone | 770-345-6600
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Fax | 770-345-6611
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 066629
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License Number State | GA
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