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Organization

LAWRENCE MEDICAL GROUP

Active
Other names
RENEGADE HEALTH
Organization subpart
No

Provider details

NPI number
Authorized official
WENDY WHITE (CREDENTIALING SPECIALIST)
(304) 688-7027
Entity
Organization

Contact information

Practice address
1700 COOK PARKWAY, SUITE 1, OCEANA, WY 24870
(304) 601-5549
(304) 310-1599
Mailing address
PO BOX 301, MOUNT GAY, WV 25637-0301
(304) 688-7027
(304) 310-1599

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
07/17/2024
Last updated
03/12/2025
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