Laurencio Christopher Lopez, PA-C
Physician Assistant, Medical in Fort Campbell, KY. Individual provider (NPI-1).
NPI number1497112866
StatusActive
Last updated in NPPESMay 30, 2025
Details
- NPI
- 1497112866
- Entity type
- Individual (NPI-1)
- Name
- Laurencio Christopher Lopez
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 15, 2016
- Certification date
- May 30, 2025
- Last updated
- May 30, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | 1130762 | TX | Yes |
Practice location
650 Joel DrFort Campbell, KY 42223-5318
Phone 270-798-8500
Mailing address
2998 Trough Springs RdClarksville, TN 37043-5414
Phone 931-561-8125
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All 18 Medical Physician Assistant providers in Fort Campbell · All 1,373 providers in Fort Campbell
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