MEDICARE: DR. JAMES DALE LAWRENZI DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	05-38315	KS
2	207Q00000X	Family Medicine Physician	2008021948	MO

General Provider Information

NPI Number	:	1174550313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES DALE LAWRENZI DO

Provider Business Mailing Address
First Line	:	793 NW 1621ST RD
Second Line	:
City	:	BATES CITY
State	:	MO
Zip	:	64011-8395
Country	:	US
Telephone Number	:	816-226-1182
Fax Number	:	844-384-5035

Provider Business Practice Location Address
First Line	:	793 NW 1621ST RD
Second Line	:
City	:	BATES CITY
State	:	MO
Zip	:	64011-8395
Country	:	US
Telephone Number	:	816-226-1182
Fax Number	:	816-466-8821

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	12/12/2024

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