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General NPI Number Information
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NPI Number | 1396945218
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Entity Type | Organization
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Legal Business Name | CHARLES D LAWLER, O.D.
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 07/10/2009
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Provider Practice Location Address
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Address Line | 369 W CHURCH ST
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City | LEXINGTON
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State | TN
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Zip | 38351-2096
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Country | US
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Telephone | 731-967-3291
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Fax |
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Provider Business Mailing Address
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Address Line | 369 W CHURCH ST
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City | LEXINGTON
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State | TN
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Zip | 38351-2096
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Country | US
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Telephone | 731-967-3291
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES DAVID LAWLER
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Credential | O.D.
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Telephone | 731-968-5225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | ODT455
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | ODT455
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License Number State | TN
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