Individual
DR. LAWRENCE HOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
655 W 8TH ST, UFJP RADIOLOGY DEPT., JACKSONVILLE, FL 32209-6511
(904) 244-4229
(904) 244-3382
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3660
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
ME80894
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME80894
FL
Other
Enumeration date
02/16/2006
Last updated
09/03/2007
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