MEDICARE: DR. LOUIE CHESTER LAWSON JR. MD

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	208D00000X	General Practice Physician	12541	SC

General Provider Information

NPI Number	:	1669184685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIE CHESTER LAWSON JR. MD

Provider Business Mailing Address
First Line	:	1514 MUD BRIDGE RD
Second Line	:
City	:	BUFFALO
State	:	SC
Zip	:	29321-2411
Country	:	US
Telephone Number	:	843-602-1460
Fax Number	:

Provider Business Practice Location Address
First Line	:	1514 MUD BRIDGE RD
Second Line	:
City	:	BUFFALO
State	:	SC
Zip	:	29321-2411
Country	:	US
Telephone Number	:	843-602-1460
Fax Number	:

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

Provider Enumeration Date	:	12/21/2022
Last Update Date	:	12/21/2022

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