MEDICARE: LAWRENCE ALLAN CLAIBORNE DVM

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	174400000X	Specialist	5840	TN

General Provider Information

NPI Number	:	1619450160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAWRENCE ALLAN CLAIBORNE DVM

Provider Business Mailing Address
First Line	:	370 MORGAN RD
Second Line	:
City	:	GREENEVILLE
State	:	TN
Zip	:	37745-3118
Country	:	US
Telephone Number	:	423-620-8622
Fax Number	:	423-639-0743

Provider Business Practice Location Address
First Line	:	370 MORGAN RD
Second Line	:
City	:	GREENEVILLE
State	:	TN
Zip	:	37745-3118
Country	:	US
Telephone Number	:	423-620-8622
Fax Number	:	423-639-0743

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

Provider Enumeration Date	:	09/11/2018
Last Update Date	:	09/11/2018

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