Healthcare Provider Details

I. General information

NPI: 1134494479
Provider Name (Legal Business Name): MEGAN ELIZABETH LAWLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2012
Last Update Date: 07/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 JESSE HILL JR DR SE FACULTY OFFICE BLDG
ATLANTA GA
30303-3049
US

IV. Provider business mailing address

49 JESSE HILL JR DR SE FACULTY OFFICE BLDG
ATLANTA GA
30303-3049
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-3401
  • Fax:
Mailing address:
  • Phone: 404-778-3401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number75550
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: