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NPI Code Detail

MEDICARE: DR. GARY MONROE LAWRENCE M.D.

MEDICARE: DR. GARY MONROE LAWRENCE 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
1207Q00000XFamily Medicine Physician14150OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1100135780BOTHEROKSOONERCARE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376529511
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY MONROE LAWRENCE M.D.
Provider Business Mailing Address
First Line : 4401 W MEMORIAL RD
Second Line : SUITE 140
City : OKLAHOMA CITY
State : OK
Zip : 73134-1785
Country : US
Telephone Number : 405-752-3162
Fax Number : 405-936-5211
Provider Business Practice Location Address
First Line : 1919 E MEMORIAL RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73131-1253
Country : US
Telephone Number : 405-341-7009
Fax Number : 405-330-1811
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2005
Last Update Date : 05/20/2014

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