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General NPI Number Information
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NPI Number | 1427217611
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Entity Type | Organization
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Legal Business Name | B. BROOKS LAWRENCE, M.D., P.A.
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 3650 COLLEGE AVE
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City | CONWAY
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State | AR
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Zip | 72034-7272
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Country | US
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Telephone | 501-327-6900
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Fax | 501-327-3690
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Provider Business Mailing Address
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Address Line | PO BOX 10581
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City | CONWAY
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State | AR
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Zip | 72034-0009
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Country | US
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Telephone | 501-327-6900
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Fax | 501-327-3690
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. B BROOKS LAWRENCE
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Credential | M.D.
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Telephone | 501-327-6900
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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 | C8006
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License Number State | AR
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