Provider Demographics
NPI:1417925884
Name:LAWTON, ERIC DAVID (CRNA)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:DAVID
Last Name:LAWTON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 KNIGHT FARM RD
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-1683
Mailing Address - Country:US
Mailing Address - Phone:678-920-3177
Mailing Address - Fax:
Practice Address - Street 1:25 WELLS ST
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-2922
Practice Address - Country:US
Practice Address - Phone:401-596-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRNA36648367500000X
FL2784662367500000X
GARN178631367500000X
MA239190367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG2982OtherBCBS OF FLORIDA
FL304575700Medicaid
RI007059209Medicare PIN
FL304575700Medicaid
FLG2982OtherBCBS OF FLORIDA