Provider Demographics
NPI:1356312169
Name:LAWSING, JAMES FULLER III (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:FULLER
Last Name:LAWSING
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 HOMER AVE PO BOX 628
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-0628
Mailing Address - Country:US
Mailing Address - Phone:607-758-3750
Mailing Address - Fax:607-758-3754
Practice Address - Street 1:1095 COMMONS AVE
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-0628
Practice Address - Country:US
Practice Address - Phone:607-758-3750
Practice Address - Fax:607-758-3754
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106464-1207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME110050099Medicaid
D79242Medicare UPIN
077704Medicare PIN