Healthcare Provider Details

I. General information

NPI: 1891949632
Provider Name (Legal Business Name): CHARLTON DAVID LAWHORN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2008
Last Update Date: 11/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 S KANSAS AVE SUITE 800
TOPEKA KS
66603-3451
US

IV. Provider business mailing address

534 S KANSAS AVE SUITE 800
TOPEKA KS
66603-3451
US

V. Phone/Fax

Practice location:
  • Phone: 785-234-5100
  • Fax: 785-233-0173
Mailing address:
  • Phone: 785-234-5100
  • Fax: 785-233-0173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number04-21680
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberN-8018
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: