Provider Demographics
NPI:1548224124
Name:JONES, LAWRENCE W (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:W
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:112 N MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1710
Mailing Address - Country:US
Mailing Address - Phone:626-796-8102
Mailing Address - Fax:626-796-8060
Practice Address - Street 1:112 N MADISON AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1710
Practice Address - Country:US
Practice Address - Phone:626-796-8102
Practice Address - Fax:626-796-8060
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA21999208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW5818OtherGROUP PTAN
CA340004151OtherRAILROAD MEDICARE
CAW5818OtherGROUP PTAN
CAWA21999AMedicare PIN