Provider Demographics
NPI:1417984196
Name:LAWLOR, JAMES M (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:LAWLOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-7777
Mailing Address - Fax:
Practice Address - Street 1:300 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1280
Practice Address - Country:US
Practice Address - Phone:614-293-7777
Practice Address - Fax:614-293-8979
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007784207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2414355Medicaid
OHH338650Medicare PIN
OH2414355Medicaid
LA7335351OtherTRICARE
87726OtherUHC
341407259OtherNATIONWIDE
341407259OtherCIGNA
LA7335351Medicare ID - Type Unspecified
7755544OtherAETNA
H91565Medicare UPIN