Provider Demographics
NPI:1548205511
Name:LAWTON, MEGAN GRACE (DPM, MS)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:GRACE
Last Name:LAWTON
Suffix:
Gender:F
Credentials:DPM, MS
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:37 APPLE ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:DELLWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55110-1234
Mailing Address - Country:US
Mailing Address - Phone:239-784-4029
Mailing Address - Fax:
Practice Address - Street 1:2599 WHITE BEAR AVE N
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-5171
Practice Address - Country:US
Practice Address - Phone:651-770-3891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3231213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4521140001Medicare NSC
FLAB639ZMedicare PIN
FLV11701Medicare UPIN