Provider Demographics
NPI:1033340179
Name:MICHAEL P LAWLER MD S CORP
Entity Type:Organization
Organization Name:MICHAEL P LAWLER MD S CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:LAWLER MD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-967-7660
Mailing Address - Street 1:1129 N CARBON ST STE 3
Mailing Address - Street 2:PO BOX 1763
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-1068
Mailing Address - Country:US
Mailing Address - Phone:618-967-7660
Mailing Address - Fax:
Practice Address - Street 1:1129 N CARBON ST STE 3
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-1068
Practice Address - Country:US
Practice Address - Phone:618-967-7660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036123376207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty