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General NPI Number Information
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NPI Number | 1255454286
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Entity Type | Organization
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Legal Business Name | LAWRENCE W BENCE MD PC
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 02/16/2012
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Provider Practice Location Address
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Address Line | 150 S MAIN ST
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City | FLORENCE
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State | AZ
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Zip | 85132-3012
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Country | US
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Telephone | 520-868-5811
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Fax | 520-868-1223
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Provider Business Mailing Address
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Address Line | PO BOX 669 150 S MAIN ST
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City | FLORENCE
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State | AZ
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Zip | 85132-3012
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Country | US
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Telephone | 520-868-5811
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Fax | 520-868-1223
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Authorized Official
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Title or Position | OWNER
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Name | LAWRENCE W BENCE
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Credential | MD
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Telephone | 520-868-5811
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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 | 15656
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License Number State | AZ
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