Healthcare Provider Details

I. General information

NPI: 1942292313
Provider Name (Legal Business Name): JOHN DOUGLAS LAWSON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 WESTLAKES DR STE 3152
BERWYN PA
19312-2410
US

IV. Provider business mailing address

PO BOX 40412
BELFAST ME
04915-1255
US

V. Phone/Fax

Practice location:
  • Phone: 215-346-6050
  • Fax: 215-220-3562
Mailing address:
  • Phone: 248-824-6500
  • Fax: 855-618-6655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS013162
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: