Individual
DR. LAWRENCE J MATHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
229 HEDRICK DR, NEWPORT, TN 37821-2902
(423) 623-1057
(423) 625-8620
Mailing address
229 HEDRICK DR, NEWPORT, TN 37821-2902
(423) 623-1057
(423) 625-8620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD37301
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100043255
PHP TENNCARE
TN
05
—
3886126
—
TN
01
—
4070939
BLUECARE-NEWPORT
TN
01
—
4071754
BCBST
TN
01
—
4071763
BCBST
TN
01
—
4071787
BCBST
TN
01
—
4071792
BCBST
TN
Enumeration date
01/26/2006
Last updated
11/14/2014
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