Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Maxfield Roy Lawrence, PA-C

Individual provider Physician Assistant · NPI 1578232815

Maxfield Roy Lawrence, PA-C is a Physician Assistant in Fruitland, Idaho. Qualified in 2021, 5 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Idaho.

Years since qualifying
5
Licensed in
ID
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1118 NW 16th St Ste D
Fruitland, ID 83619-2272
Phone: (208) 452-7677
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-2104 (ID)

Record details

NPI number1578232815
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 9, 2021
Last updated in NPPESJanuary 9, 2025
Certification dateJanuary 9, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

Other providers in Fruitland