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General NPI Number Information
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NPI Number | 1386978872
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Entity Type | Organization
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Legal Business Name | LAWSON FAMILY MEDICINE AND AESTHETICS LLC
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 09/30/2009
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Provider Practice Location Address
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Address Line | 1454 ROANOKE RD
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City | DALEVILLE
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State | VA
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Zip | 24083
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Country | US
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Telephone | 540-992-3600
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Fax | 540-992-5570
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Provider Business Mailing Address
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Address Line | PO BOX 429
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City | DALEVILLE
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State | VA
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Zip | 24083-0429
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Country | US
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Telephone | 540-992-3600
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Fax | 540-992-5570
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Authorized Official
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Title or Position | SOLE MEMBER/PHYSICIAN
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Name | LIANNA R LAWSON
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Credential | D.O.
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Telephone | 540-992-3600
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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 | 0102050181
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License Number State | VA
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