Individual
CONRAD M LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2080 W SOUTHERN AVE, BLDG. B10, APACHE JUNCTION, AZ 85120-7455
(480) 351-2850
(480) 351-2851
Mailing address
PO BOX 10097, CASA GRANDE, AZ 85130-0020
(480) 351-2850
(480) 351-2851
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
48947
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031918
MEDICARE
—
01
—
Z168007
MEDICARE
—
Enumeration date
04/07/2010
Last updated
07/21/2022
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