Individual
DR. LAWRENCE ADRIAN ROUTT SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
107 S NATCHEZ ST, KOSCIUSKO, MS 39090-3741
(662) 289-4131
(662) 289-5348
Mailing address
107 S NATCHEZ ST, KOSCIUSKO, MS 39090-3741
(662) 289-4131
(662) 289-5348
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
471
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087888
—
MS
Enumeration date
01/10/2006
Last updated
01/07/2008
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