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General NPI Number Information
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NPI Number | 1801895206
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Entity Type | Individual
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Provider Name | LAWRENCE W WHITLOCK MD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 11/30/2011
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Provider Practice Location Address
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Address Line | 3725 CHAMPION HILLS DR SUITE 2000
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City | MEMPHIS
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State | TN
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Zip | 38125-2597
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Country | US
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Telephone | 901-367-9001
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Fax | 901-565-8787
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Provider Business Mailing Address
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Address Line | PO BOX 1000 DEPT 362
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City | MEMPHIS
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State | TN
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Zip | 38148-0362
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Country | US
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Telephone | 901-373-9704
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Fax | 901-255-5223
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 8296
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License Number State | TN
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