Provider Demographics
NPI:1033422449
Name:LAWSON, ELISABETH J (OD)
Entity Type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:J
Last Name:LAWSON
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:1400 MARKET PLACE BLVD STE 154
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7925
Mailing Address - Country:US
Mailing Address - Phone:770-292-9015
Mailing Address - Fax:678-513-4175
Practice Address - Street 1:1525 MARKET PLACE BLVD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7935
Practice Address - Country:US
Practice Address - Phone:770-292-9015
Practice Address - Fax:678-513-4175
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2021-11-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC2310152W00000X
MS830152W00000X
TN2932152W00000X
GAOPT002702152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist