Individual
BETHANY J LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
294 SUMMAR DR, JACKSON, TN 38301-3915
(731) 423-1932
(731) 423-4919
Mailing address
294 SUMMAR DR, DEPT 289, JACKSON, TN 38301-3915
(731) 265-8220
(731) 265-8355
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38605
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1445202
CIGNA
TN
01
—
186392
UNISON
TN
01
—
31851
TLC
TN
05
—
3897530
—
TN
01
—
4122467
BLUE CROSS BLUE SHIELD
TN
01
—
626001636
HEALTH PARTNERS
—
Enumeration date
06/26/2006
Last updated
07/12/2007
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