Provider Demographics
NPI:1437116571
Name:LAWSON, LORI A (MD)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:LAWSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 HENDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-2521
Mailing Address - Country:US
Mailing Address - Phone:610-832-1130
Mailing Address - Fax:
Practice Address - Street 1:1701 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-8815
Practice Address - Country:US
Practice Address - Phone:717-988-0000
Practice Address - Fax:717-782-5716
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10008287207P00000X
PAMD050496L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014314240021OtherPROMISE
PA125816OtherBS
DE1437116571Medicaid
PA30004565OtherKEYSTONE MERCY
PA001431424Medicaid
PA0667886000OtherKEYSTONE
PA30004565OtherKEYSTONE MERCY
PA0014314240021OtherPROMISE
DE022547D18Medicare PIN
DE1437116571Medicaid
PA0667886000OtherKEYSTONE