Individual
LAWRENCE LAZELLE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1367 DOMINION PLAZA, TYLER, TX 75703-1013
(903) 534-6200
Mailing address
1367 DOMINION PLAZA, TYLER, TX 75703-1013
(903) 534-6200
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
J9612
TX
207ND0101X
MOHS-Micrographic Surgery Physician
J9612
TX
Other
Enumeration date
07/03/2006
Last updated
09/15/2020
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