Provider Demographics
NPI:1538263710
Name:ARKIN, LAWRENCE MICHAEL (MD)
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:MICHAEL
Last Name:ARKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 JOHN MADDOX DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165
Mailing Address - Country:US
Mailing Address - Phone:706-290-0090
Mailing Address - Fax:706-290-1530
Practice Address - Street 1:105 JOHN MADDOX DRIVE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165
Practice Address - Country:US
Practice Address - Phone:706-290-0090
Practice Address - Fax:706-290-1530
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033020207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00430526CMedicaid
GA10060552OtherAMERIGROUP
GA10060552OtherAMERIGROUP
E97656Medicare UPIN
GA00430526CMedicaid