Provider Demographics
NPI:1114136629
Name:LAWSON, SAMUEL PAUL (PT, MS, OCS)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:PAUL
Last Name:LAWSON
Suffix:
Gender:M
Credentials:PT, MS, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 MILBRANCH PL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7634
Mailing Address - Country:US
Mailing Address - Phone:804-726-2340
Mailing Address - Fax:804-726-2341
Practice Address - Street 1:3604 MILBRANCH PL
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-7634
Practice Address - Country:US
Practice Address - Phone:804-726-2340
Practice Address - Fax:804-726-2341
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2008-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052021012251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00V925M01Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
VAC09058Medicare ID - Type UnspecifiedGROUP NUMBER