Provider Demographics
NPI:1316592439
Name:LAWSON, SAMANTHA (DO)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 SUMMERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SMITHS STATION
Mailing Address - State:AL
Mailing Address - Zip Code:36877-3295
Mailing Address - Country:US
Mailing Address - Phone:334-528-3662
Mailing Address - Fax:334-528-3661
Practice Address - Street 1:865 SUMMERVILLE RD
Practice Address - Street 2:
Practice Address - City:SMITHS STATION
Practice Address - State:AL
Practice Address - Zip Code:36877-3295
Practice Address - Country:US
Practice Address - Phone:334-528-3662
Practice Address - Fax:334-528-3661
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.2487207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine