MEDICARE: DR. STEVEN R LAWHON PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	P1181	TN

General Provider Information

NPI Number	:	1194932756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN R LAWHON PSY.D.

Provider Business Mailing Address
First Line	:	323 W WALNUT ST
Second Line	:	SUITE 201
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-6760
Country	:	US
Telephone Number	:	423-378-0011
Fax Number	:	423-246-0311

Provider Business Practice Location Address
First Line	:	323 W WALNUT ST
Second Line	:	SUITE 201
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-6760
Country	:	US
Telephone Number	:	423-378-0011
Fax Number	:	423-246-0311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	07/08/2007

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