Provider Demographics
NPI:1285182089
Name:LAWLER, ROBERT M JR (PA-C)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:LAWLER
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 REGENT CT
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7965
Mailing Address - Country:US
Mailing Address - Phone:814-231-2101
Mailing Address - Fax:814-231-8569
Practice Address - Street 1:101 REGENT CT
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7965
Practice Address - Country:US
Practice Address - Phone:814-231-2101
Practice Address - Fax:814-231-8569
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058531363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant