Provider Demographics
NPI:1346305158
Name:LAWLER, TIMOTHY K (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:K
Last Name:LAWLER
Suffix:
Gender:M
Credentials:DC
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 510
Mailing Address - Street 2:
Mailing Address - City:SUNMAN
Mailing Address - State:IN
Mailing Address - Zip Code:47041-0510
Mailing Address - Country:US
Mailing Address - Phone:812-623-4228
Mailing Address - Fax:812-623-4228
Practice Address - Street 1:8866 EAST ST. RT. #46
Practice Address - Street 2:
Practice Address - City:SUNMAN
Practice Address - State:IN
Practice Address - Zip Code:47041-0510
Practice Address - Country:US
Practice Address - Phone:812-623-4228
Practice Address - Fax:812-623-4228
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001279111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN701580AMedicare PIN
U13347Medicare UPIN