Provider Demographics
NPI:1558372789
Name:LAWLEY, CHRISTOPHER DONALD (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DONALD
Last Name:LAWLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 W LOCUST ST
Mailing Address - Street 2:STE 600
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-2063
Mailing Address - Country:US
Mailing Address - Phone:937-382-4817
Mailing Address - Fax:937-383-2630
Practice Address - Street 1:1150 W LOCUST ST
Practice Address - Street 2:STE 600
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-2063
Practice Address - Country:US
Practice Address - Phone:937-382-1141
Practice Address - Fax:937-383-2630
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3779208800000X
OHOH34004502208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0707015Medicaid
OH0972925Medicaid
LA0610973Medicare ID - Type Unspecified
E00758Medicare UPIN
S09266901Medicare ID - Type UnspecifiedGROUP