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General NPI Number Information
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NPI Number | 1861856460
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Entity Type | Individual
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Provider Name | JAMAL LAWRENCE MD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2016
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 130 TIBET AVE SUITE 108
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City | SAVANNAH
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State | GA
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Zip | 31406
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Country | US
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Telephone | 912-421-9143
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Fax | 270-220-0452
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Provider Business Mailing Address
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Address Line | 130 TIBET AVE APT 108
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City | SAVANNAH
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State | GA
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Zip | 31406-9029
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Country | US
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Telephone | 912-421-9143
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Fax | 270-220-0452
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 83908
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License Number State | GA
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