Provider Demographics
NPI:1326729120
Name:LAWSON, ZACKARY DYLAN
Entity Type:Individual
Prefix:
First Name:ZACKARY
Middle Name:DYLAN
Last Name:LAWSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-3714
Mailing Address - Country:US
Mailing Address - Phone:910-499-2880
Mailing Address - Fax:
Practice Address - Street 1:308 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-3714
Practice Address - Country:US
Practice Address - Phone:910-499-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program