MEDICARE: DR. THOMAS C LAWFORD M.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	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	0101019896	VA
2	207R00000X	Internal Medicine Physician	0101019896	VA

General Provider Information

NPI Number	:	1396865440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS C LAWFORD M.D.

Provider Business Mailing Address
First Line	:	2148 GLENCOURSE LN
Second Line	:
City	:	RESTON
State	:	VA
Zip	:	20191-1317
Country	:	US
Telephone Number	:	703-476-5155
Fax Number	:	888-854-8839

Provider Business Practice Location Address
First Line	:	2148 GLENCOURSE LN
Second Line	:
City	:	RESTON
State	:	VA
Zip	:	20191-1317
Country	:	US
Telephone Number	:	703-476-5155
Fax Number	:	888-854-8839

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

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	02/08/2026

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