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Individual
BRENT MARTELL LAWRENCE
Active
Individual
BRENT MARTELL LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
E8177
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206117001
—
AR
01
—
370913ZG8E
MEDICARE PTAN
—
01
—
5I434
BCBS
AR
Enumeration date
06/19/2008
Last updated
11/21/2019
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