Lawrence D Anderson MD Estate

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

LAWRENCE D ANDERSON MD ESTATE

Practice address

8955 W Hackamore Dr
Boise, ID 83709

Phone

(208) 344-7944

Fax

(208) 343-4676

NPI assigned

Nov 2, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Nathan B Anderson

Title

Personal Representative

Phone

(208) 344-7944

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Maple Grove Eye Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1326550096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8955 W HACKAMORE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709",
            "telephone_number": "208-344-7944",
            "fax_number": "208-343-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8955 W HACKAMORE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709",
            "telephone_number": "208-344-7944",
            "fax_number": "208-343-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE D ANDERSON MD ESTATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-02",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PERSONAL REPRESENTATIVE",
        "authorized_official_telephone_number": "208-344-7944",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942316054",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326302548",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maple Grove Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Krys-Ann Janell Lawhorn, LMSW
• Christopher T Lawler, MD
• Helen Lawler, PA
• Janet Lawler
• Camarin Lawlor, M.S., CCC-SLP
• Ariana Lawrence, MS, RD, LD
• Braden Lawrence, MD
• Grace Anne Lawrence, PHARMD, CGP
• Holly G Lawrence, RN BSN
• Joshua James Lawrence, PA-C

• Ophthalmology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Ophthalmology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.