Individual
MR. RUSSELL FRANKLIN LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
VETERANS AFFAIRS MEDICAL CENTER, LAMONT AND SYDNEY STREETS, MOUNTAIN HOME, TN 37684-4000
(423) 926-1171
(423) 979-3518
Mailing address
141 ROSECLIFF DR, FALL BRANCH, TN 37656-2235
(423) 348-6814
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0000000175
TN
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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