MEDICARE: LAWRENCE HOWARD MEYER MD

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	C7721	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1386633691	OTHER	AR	NPI
2	17429000000	OTHER	AR	QUALCHOICE QCA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386633691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE HOWARD MEYER MD

Provider Business Mailing Address
First Line	:	PO BOX 1060
Second Line	:
City	:	MARSHALL
State	:	AR
Zip	:	72650-1060
Country	:	US
Telephone Number	:	870-448-5733
Fax Number	:	870-448-3392

Provider Business Practice Location Address
First Line	:	465 MEDICAL CENTER PARKWAY
Second Line	:
City	:	CLINTON
State	:	AR
Zip	:	72031
Country	:	US
Telephone Number	:	501-745-7888
Fax Number	:	501-745-4401

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

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	05/24/2021

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