Healthcare Provider Details

I. General information

NPI: 1053843508
Provider Name (Legal Business Name): ERIC CHRISTOPHER LAWSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 CLIFTON RD NE
ATLANTA GA
30322-3049
US

IV. Provider business mailing address

723 NEEDLETAIL WAY
ATLANTA GA
30312-3320
US

V. Phone/Fax

Practice location:
  • Phone: 404-712-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License Number88442
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: