=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295992386
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JEFFREY DAVID LAWLER M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2008
-----------------------------------------------------
Last Update Date | 04/05/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1419 HAMRIC DR E STE 201
-----------------------------------------------------
City | OXFORD
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36203-2181
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-241-4842
-----------------------------------------------------
Fax | 256-241-3254
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1419 HAMRIC DR E STE 201
-----------------------------------------------------
City | OXFORD
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36203-2181
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 256-241-4842
-----------------------------------------------------
Fax | 256-241-3254
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | 134560
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | MD.30847
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------