Provider Demographics
NPI:1871927806
Name:LAWRENCE, LANGDON SWAIN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:LANGDON
Middle Name:SWAIN
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 526
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-0526
Mailing Address - Country:US
Mailing Address - Phone:802-578-3435
Mailing Address - Fax:
Practice Address - Street 1:4276 SILVER ST
Practice Address - Street 2:
Practice Address - City:HINESBURG
Practice Address - State:VT
Practice Address - Zip Code:05461-9492
Practice Address - Country:US
Practice Address - Phone:802-578-3435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420010061207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine