Provider Demographics
NPI:1457678765
Name:JOHN C. LAWYER O.D., LTD.
Entity Type:Organization
Organization Name:JOHN C. LAWYER O.D., LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:LAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:702-454-9664
Mailing Address - Street 1:4023 E SUNSET RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-0215
Mailing Address - Country:US
Mailing Address - Phone:702-454-9664
Mailing Address - Fax:702-454-6338
Practice Address - Street 1:4023 E SUNSET RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-0215
Practice Address - Country:US
Practice Address - Phone:702-454-9664
Practice Address - Fax:702-454-6338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV254332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VOD254Medicare PIN
0991970001Medicare NSC
U16361Medicare UPIN