Provider Demographics
NPI:1477433894
Name:MARTIN, LAWERENCE IV
Entity type:Individual
Prefix:
First Name:LAWERENCE
Middle Name:
Last Name:MARTIN
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-4822
Mailing Address - Country:US
Mailing Address - Phone:337-269-1169
Mailing Address - Fax:
Practice Address - Street 1:928 W 4TH ST
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-4822
Practice Address - Country:US
Practice Address - Phone:337-269-1169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant