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General NPI Number Information
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NPI Number | 1982985602
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Entity Type | Individual
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Provider Name | JOHN EDWARD LAWSON RPH
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Gender | Male
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Dates
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Enumeration Date | 09/08/2011
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Last Update Date | 10/05/2012
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Provider Practice Location Address
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Address Line | 1720 W. GRAND
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City | SPRINGFIELD
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State | MO
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Zip | 65802-4870
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Country | US
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Telephone | 417-874-7428
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Fax | 417-874-7430
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Provider Business Mailing Address
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Address Line | 3872 E STANFORD ST
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City | SPRINGFIELD
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State | MO
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Zip | 65809-2270
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Country | US
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Telephone | 417-773-9727
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2000145235
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License Number State | MO
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