Healthcare Provider Details

I. General information

NPI: 1215980420
Provider Name (Legal Business Name): RICHARD LAWRENCE LAWTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 09/25/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 E 30TH ST STE 101
FARMINGTON NM
87401-8990
US

IV. Provider business mailing address

2300 E 30TH ST STE 101
FARMINGTON NM
87401-8990
US

V. Phone/Fax

Practice location:
  • Phone: 53-271-4005
  • Fax: 55-643-2025
Mailing address:
  • Phone: 505-327-1400
  • Fax: 505-564-3202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD-45982
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number11200
License Number StateSD
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number39283
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: