Provider Demographics
NPI:1063626018
Name:PRESANT, LAWRENCE (DO)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:PRESANT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:18065 N THOMPSON PEAK PKWY APT 1016
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6190
Mailing Address - Country:US
Mailing Address - Phone:480-945-0910
Mailing Address - Fax:480-391-8711
Practice Address - Street 1:3805 E BELL RD
Practice Address - Street 2:STE 1600
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2105
Practice Address - Country:US
Practice Address - Phone:480-945-0910
Practice Address - Fax:480-391-8711
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2017-08-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ3610202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZE16673Medicare UPIN