Individual
DR. PETER G LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28 MEDICAL CENTER DR, JACKSON, TN 38301-3947
(731) 427-9971
(731) 424-2052
Mailing address
PO BOX 1446, DYERSBURG, TN 38025-1446
(731) 427-9971
(731) 424-2052
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD0000038436
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07646597
AETNA
TN
05
—
3892671
—
TN
01
—
4083742
BLUE CROSS BLUE SHIELD
TN
01
—
8805391
CIGNA
TN
Enumeration date
11/22/2005
Last updated
03/27/2012
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