MEDICARE: DR. JOHN C. LAWYER O.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	152W00000X	Optometrist	NV254	NV

General Provider Information

NPI Number	:	1952483596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN C. LAWYER O.D.

Provider Business Mailing Address
First Line	:	4023 E SUNSET RD
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-0215
Country	:	US
Telephone Number	:	702-454-9664
Fax Number	:	702-454-6339

Provider Business Practice Location Address
First Line	:	4023 E SUNSET RD
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-0215
Country	:	US
Telephone Number	:	702-454-9664
Fax Number	:	702-454-6339

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	12/05/2012

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