Individual
JONATHAN ROBIN LAWRENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 546-1000
Mailing address
777 HOSPITAL WAY, POCATELLO, ID 83201-5175
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
R71582
AZ
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
M-12756
ID
Other
Enumeration date
10/02/2009
Last updated
07/07/2015
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