Provider Demographics
NPI:1255494316
Name:LAWS, RICHARD A (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:LAWS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1746
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-6331
Mailing Address - Country:US
Mailing Address - Phone:615-452-1201
Mailing Address - Fax:
Practice Address - Street 1:600 COMMONS DR
Practice Address - Street 2:STE 101
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-6330
Practice Address - Country:US
Practice Address - Phone:615-452-1201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD405152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3591482Medicaid
TNU01080Medicare UPIN
TN3591482Medicaid