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General NPI Number Information
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NPI Number | 1851579569
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Entity Type | Organization
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Legal Business Name | LAWRENCE M ARKIN MD
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 105 JOHN MADDOX DRIVE NW
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City | ROME
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State | GA
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Zip | 30165-1419
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Country | US
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Telephone | 706-290-0090
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Fax | 706-290-1530
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Provider Business Mailing Address
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Address Line | 105 JOHN MADDOX DR NW
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City | ROME
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State | GA
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Zip | 30165-1419
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Country | US
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Telephone | 706-290-0090
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Fax | 706-290-1530
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAWRENCE M ARKIN
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Credential | MD
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Telephone | 706-290-0090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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