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General NPI Number Information
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NPI Number | 1679870612
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Entity Type | Organization
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Legal Business Name | LAWSON MEDICAL MANAGEMENT SERVICES, LLC
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Dates
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Enumeration Date | 02/25/2011
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Last Update Date | 02/25/2011
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Provider Practice Location Address
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Address Line | 127 E SHORE RD
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City | MONROE
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State | LA
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Zip | 71203-8857
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Country | US
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Telephone | 318-396-2715
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Fax | 318-397-4914
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Provider Business Mailing Address
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Address Line | PO BOX 1267
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City | MONROE
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State | LA
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Zip | 71210-1267
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Country | US
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Telephone | 318-396-2715
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Fax | 318-397-4914
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL R LAWSON
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Credential | MD
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Telephone | 318-396-2715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 201463
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License Number State | LA
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