| Mr Lawrence P Forman Iii, RD | |
|
Us Highway 491 North, Shiprock, NM 87420-0160 | |
| (505) 368-6204 | |
| (505) 368-6265 |
| Full Name | Mr Lawrence P Forman Iii |
|---|---|
| Gender | Male |
| Speciality | Dietitian, Registered |
| Location | Us Highway 491 North, Shiprock, New Mexico |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174553515 | NPI | - | NPPES |
| G2352 | Medicaid | NM | |
| 230062 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 471 (New Mexico) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Lawrence P Forman Iii, RD Po Box 160, Shiprock, NM 87420-0160 Ph: (505) 368-6401 | Mr Lawrence P Forman Iii, RD Us Highway 491 North, Shiprock, NM 87420-0160 Ph: (505) 368-6204 |
Ms. Lorraine Whitehair, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: Us Highway 491 N, Shiprock, NM 87420 Phone: 505-368-6020 Fax: 505-368-6431 | |
Ms. Holli M Scott, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: Us Hwy 491 N, Shiprock, NM 87420 Phone: 505-368-6020 Fax: 505-368-6431 | |
Kerrianne Ashley, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: Us Hwy 491 North, Shiprock, NM 87420 Phone: 505-368-6001 | |
Amber Desbah Yazzie, RDN Dietitian Medicare: Medicare Enrolled Practice Location: Us Hwy 491, Shiprock, NM 87420 Phone: 928-368-6205 | |
Jenna P Cope, MPH, RD, LD Dietitian Medicare: Medicare Enrolled Practice Location: Hwy 491 North, P.o. Box 160, Shiprock, NM 87420 Phone: 505-368-6001 | |
Mr. Joseph Farar, MS, RDN, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: Hwy 491 North, Northern Navajo Medical Center, Shiprock, NM 87420 Phone: 505-368-6001 |