| Mark Allen Lawrence, PA | |
|
Jct Us Hwy 160 & Navajo Route 35 Red Mesa, Teecnospos, AZ 86514 | |
| (928) 656-5165 | |
| (928) 656-5164 |
| Full Name | Mark Allen Lawrence |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | Jct Us Hwy 160 & Navajo Route 35 Red Mesa, Teecnospos, Arizona |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912994252 | NPI | - | NPPES |
| 06831371 | Medicaid | NM | |
| 09358251 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 1845 (Arizona) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Allen Lawrence, PA Hcr 6100 Box 30, Teecnospos, AZ 86514 Ph: (928) 656-5165 | Mark Allen Lawrence, PA Jct Us Hwy 160 & Navajo Route 35 Red Mesa, Teecnospos, AZ 86514 Ph: (928) 656-5165 |
Mr. Ralph Henry Smith Jr., PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: Us Hwy 160 & Navajo Route 35- Red Mesa, Teecnospos, AZ 86514 Phone: 928-656-5000 |