Provider Demographics
NPI:1356432637
Name:MERIDETH, LAWREN A (M D)
Entity type:Individual
Prefix:DR
First Name:LAWREN
Middle Name:A
Last Name:MERIDETH
Suffix:
Gender:F
Credentials:M D
Other - Prefix:DR
Other - First Name:LAWREN
Other - Middle Name:A
Other - Last Name:DOUGLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M D
Mailing Address - Street 1:3280 MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-8022
Mailing Address - Country:US
Mailing Address - Phone:405-579-5858
Mailing Address - Fax:405-292-1787
Practice Address - Street 1:3280 MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-8022
Practice Address - Country:US
Practice Address - Phone:405-579-5858
Practice Address - Fax:405-292-1787
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK224642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry