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NPI Code Detail

MEDICARE: MR. LAWRENCE THEODORE MURRAY II

MEDICARE: MR. LAWRENCE THEODORE MURRAY II
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1881357606
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LAWRENCE THEODORE MURRAY II
Provider Business Mailing Address
First Line : 2975 STARGAZE DR
Second Line :
City : DARDENNE PRAIRIE
State : MO
Zip : 63368-8069
Country : US
Telephone Number : 636-485-0168
Fax Number :
Provider Business Practice Location Address
First Line : 2000 UNIVERSITY AVE
Second Line :
City : DUBUQUE
State : IA
Zip : 52001-5099
Country : US
Telephone Number : 563-589-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2021
Last Update Date : 12/29/2022

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Directions to “ MR. LAWRENCE THEODORE MURRAY II ” Practice Location

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