Laurence, Jody B

Laurence, Jody B is an sole proprietor health care provider with primary practice located at 5 Medical Plaza Dr Ste 110 , Roseville CA 95661-2866. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, which is considered as his primary health care specialty. Laurence, Jody B can be contacted via phone (916) 483-1493.

Contact Information

Primary practice address
5 Medical Plaza Dr Ste 110 Roseville CA 95661-2866
Phone: (916) 483-1493
Fax: (888) 411-8530
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X E4155 California

Profile Details

NPI number 1972685378
LBN Legal business name Laurence, Jody B
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 19th, 2006
Last updated Aug 1st, 2016 - about 10 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 1972685378 NPPES
California MEDICAID 000E41550

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