Individual
LAWRENCE H PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4402 CHURCHMAN AVE, SUITE 404, LOUISVILLE, KY 40215-1190
(502) 363-4156
(502) 363-4158
Mailing address
PO BOX 30563, BELFAST, ME 04915-2057
(888) 488-8289
(502) 919-9780
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
31716
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64713167
—
KY
Enumeration date
01/24/2006
Last updated
05/16/2022
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