Provider Demographics
NPI:1467563239
Name:LAWLER, DOUGLAS REED II (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:REED
Last Name:LAWLER
Suffix:II
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 1:18377 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-5337
Mailing Address - Country:US
Mailing Address - Phone:276-676-3150
Mailing Address - Fax:
Practice Address - Street 1:351 COURT ST
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2921
Practice Address - Country:US
Practice Address - Phone:276-676-7000
Practice Address - Fax:276-676-9366
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042381207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100150100Medicaid
VA080003542Medicare ID - Type Unspecified
VA930030920Medicare ID - Type UnspecifiedRAILROAD MEDICARE
VAVAA113316Medicare PIN
C36661Medicare UPIN