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General NPI Number Information
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NPI Number | 1972809382
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Entity Type | Individual
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Provider Name | JONATHAN LAWRENCE MD
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Gender | Male
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Dates
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Enumeration Date | 02/02/2011
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 56 HOSPITAL ST
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City | HIAWASSEE
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State | GA
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Zip | 30546-3251
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Country | US
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Telephone | 706-896-7858
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Fax | 706-896-0877
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Provider Business Mailing Address
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Address Line | 229 CHATUGE WAY
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City | HIAWASSEE
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State | GA
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Zip | 30546-3439
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 72789
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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