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General NPI Number Information
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NPI Number | 1265599591
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Entity Type | Individual
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Provider Name | LAWRENCE PAUL LANDWEHR M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 407 A. EAST RUSSELL AVENUE SUITE 3
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City | WARRENSBURG
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State | MO
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Zip | 64093
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Country | US
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Telephone | 660-422-7000
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Fax | 660-747-0409
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Provider Business Mailing Address
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Address Line | 407 A EAST RUSSELL AVENUE SUITE 3
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City | WARRENSBURG
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State | MO
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Zip | 64093-2958
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Country | US
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Telephone | 660-422-7000
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Fax |
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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 | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | MD111733
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License Number State | MO
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