Provider Demographics
NPI:1043698426
Name:DR. JAMES T. LAWLER M.D. S.C.
Entity Type:Organization
Organization Name:DR. JAMES T. LAWLER M.D. S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:LAWLER
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:618-518-7700
Mailing Address - Street 1:1129 N CARBON ST
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:618-518-7700
Mailing Address - Fax:618-997-6441
Practice Address - Street 1:1129 N CARBON ST
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:618-518-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036138280207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty