Doctor Name: | MR. JAMES SIDNEY LORENZ |
NPI Number: | 1891875357 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 3470 |
Business Practice Address: | Evans Army Community Hospital (each) Usa Meddac Diraimondo Family Medicine Clinic, 1041 Barkley Ave. Ft. Carson, CO - 809134604 |
Business Phone Number: | 7194572273 |
Business Fax Number: | 7195243526 |
Mailing Address: | 7862a Just Cause Dr., FT. CARSON |
State: | CO |
Postal Code: | 80902 |
Phone Number: | 5206091639 |
Fax Number: | |
NPI Enumeration Date: | 10/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 3470 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |