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General NPI Number Information
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NPI Number | 1235576752
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Entity Type | Individual
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Provider Name | JUSTIN SCOTT LAWING DO
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Gender | Male
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Dates
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Enumeration Date | 05/23/2013
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Last Update Date | 06/13/2018
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Provider Practice Location Address
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Address Line | 6420 N PROSPECT AVE
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City | GLADSTONE
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State | MO
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Zip | 64119
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Country | US
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Telephone | 913-945-9700
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Fax | 913-945-9707
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Provider Business Mailing Address
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Address Line | 6420 N PROSPECT AVE
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City | GLADSTONE
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State | MO
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Zip | 64119-1530
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Country | US
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Telephone | 913-945-9700
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Fax | 913-945-9707
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9408100
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2016013406
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License Number State | MO
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