Provider Demographics
NPI:1508823592
Name:LAWS, HARRY FORD II (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:FORD
Last Name:LAWS
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 1:9555 76TH STREET
Mailing Address - Street 2:4106
Mailing Address - City:PLEASANT PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53158-1984
Mailing Address - Country:US
Mailing Address - Phone:262-653-5437
Mailing Address - Fax:262-653-5850
Practice Address - Street 1:4855 S MOORLAND RD
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-7494
Practice Address - Country:US
Practice Address - Phone:262-432-7599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH17708208000000X
IN01043200A208000000X
VT042.0013318208000000X
WI66583-20208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1508823592Medicaid
IN200408090Medicaid
INP01512415OtherRR MEDICARE
INP01512415OtherRR MEDICARE