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Individual

JOHN P LAWRENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4801 ALBERTA AVE, EL PASO, TX 79905-2707
(915) 215-5300
(915) 215-8606
Mailing address
440 RAYNOLDS ST # 51015, EL PASO, TX 79905-1613
(915) 215-4480
(915) 215-5386

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
29467
IA
2086S0120X
Pediatric Surgery Physician
Primary
S8332
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0101576
IA
01
12174
WELLMARK BCBS
IA
Enumeration date
08/10/2005
Last updated
11/24/2020
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