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NPI Code Detail

MEDICARE: MR. MARC LAWSON P.A.-C

MEDICARE: MR. MARC LAWSON P.A.-C
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
1363AM0700XMedical Physician Assistant348763-1206UT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1005592414OTHERUTMCR
21285756825OTHERUTNPI
353699191200001OTHERUTBCBS

General Provider Information

NPI Number : 1285756825
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARC LAWSON P.A.-C
Provider Business Mailing Address
First Line : 665 EAGLEVIEW CT
Second Line :
City : PROVIDENCE
State : UT
Zip : 84332-9224
Country : US
Telephone Number : 435-232-2537
Fax Number :
Provider Business Practice Location Address
First Line : 1400 N 500 E
Second Line :
City : LOGAN
State : UT
Zip : 84341-2455
Country : US
Telephone Number : 435-753-1382
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2007
Last Update Date : 05/11/2026

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