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Individual

BRENT MARTELL LAWRENCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
800 EXCHANGE AVE STE 102B, CONWAY, AR 72032-7833
(501) 504-6994
(501) 504-6985
Mailing address
800 EXCHANGE AVE STE 102B, CONWAY, AR 72032-7833
(501) 504-6994
(501) 504-6985

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
E8177
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
206117001
AR
01
370913ZG8E
MEDICARE PTAN
01
5I434
BCBS
AR
Enumeration date
06/19/2008
Last updated
11/21/2019
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