Individual
DR. MATTHEW JON LAURENCELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6019 WALNUT GROVE RD, MEMPHIS, TN 38120-2113
(901) 226-3610
Mailing address
PO BOX 405827, ATLANTA, GA 30384-5827
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301101016
MI
2084P0800X
Psychiatry Physician
72564
TN
2084P0802X
Addiction Psychiatry Physician
4301101016
MI
Other
Enumeration date
06/15/2012
Last updated
01/08/2025
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