MEDICARE: DR. RICHARD LLOYD LAWRENCE JR. M.D.

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	207W00000X	Ophthalmology Physician	57389	GA
2	207W00000X	Ophthalmology Physician	27365	AL
3	207W00000X	Ophthalmology Physician	25403	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11552353	OTHER	GA	CAQH
2	1336197490	OTHER		NPI INDIVIDUAL

General Provider Information

NPI Number	:	1336197490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD LLOYD LAWRENCE JR. M.D.

Provider Business Mailing Address
First Line	:	939 BOB ARNOLD BLVD
Second Line	:	SUITE G
City	:	LITHIA SPRINGS
State	:	GA
Zip	:	30122-3258
Country	:	US
Telephone Number	:	678-945-3939
Fax Number	:	678-945-3935

Provider Business Practice Location Address
First Line	:	939 BOB ARNOLD BLVD
Second Line	:	SUITE G
City	:	LITHIA SPRINGS
State	:	GA
Zip	:	30122-3258
Country	:	US
Telephone Number	:	678-945-3939
Fax Number	:	678-945-3935

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	05/15/2008

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Directions to “ DR. RICHARD LLOYD LAWRENCE JR. M.D.” Practice Location

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