Individual
LAWRENCE EDWARD DEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2301 S LAMAR BLVD, SUITE 140, OXFORD, MS 38655-5373
(662) 513-3246
(662) 513-6248
Mailing address
PO BOX 405827, ATLANTA, GA 30384-5827
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
14380
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115376
—
MS
01
—
P00459709
RAILROAD MEDICARE
—
Enumeration date
05/04/2006
Last updated
10/25/2016
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