Individual
LAWRENCE PATRICK FANNON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1901 TATE SPRINGS RD, LYNCHBURG, VA 24501-1109
(424) 200-3101
(424) 200-5865
Mailing address
1901 TATE SPRINGS RD, LYNCHBURG, VA 24501-1109
(424) 200-3101
(424) 200-5865
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101262051
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/12/2014
Last updated
04/17/2017
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