Individual
JEFFREY J LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3311 RIVERBEND DR, SPRINGFIELD, OR 97477-8800
(541) 222-3531
(541) 222-2843
Mailing address
PO BOX 24410, EUGENE, OR 97402-0451
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00376
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00246689
RAILROAD MEDICARE
OR
Enumeration date
06/28/2006
Last updated
03/11/2013
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