Individual provider · NPI-1

Dr. Lawrence W. Astle, M.D.

Family Medicine, Addiction Medicine · Provo, UT

NPI number1285829309

StatusActive

Last updated in NPPESSep 11, 2007

Details

NPI: 1285829309
Entity type: Individual (NPI-1)
Name: Dr. Lawrence W. Astle
Credential: M.D.
Sex: Male
Sole proprietor: Yes
Enumeration date: Sep 11, 2007
Last updated: Sep 11, 2007

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207QA0401X	Family Medicine, Addiction Medicine	150-373-1205	UT	Yes

Practice location

151 S University Ave
Suite 1400
Provo, UT 84601-4427

Phone 801-851-7113 · Fax 801-851-7186

Mailing address

151 S University Ave
Suite 1400
Provo, UT 84601-4427

Phone 801-851-7113 · Fax 801-851-7186

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