Crockett, Lawrence O

Crockett, Lawrence O is an individual health care provider with primary practice located at 150 Nacoochee Ave , Athens GA 30601-1823. He recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as his primary health care specialty. Crockett, Lawrence O can be contacted via phone (706) 546-5689.

Contact Information

Primary practice address
150 Nacoochee Ave Athens GA 30601-1823
Phone: (706) 546-5689
Fax: (706) 543-7675
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X AUD003507 Georgia

Profile Details

NPI number 1912963141
LBN Legal business name Crockett, Lawrence O
Credentials AUD
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Jan 27th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912963141 NPPES
Georgia MEDICAID 000848273B
Georgia Other 581585042
Georgia Other 581585042
Georgia Other 584585042

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