Provider Demographics
NPI:1710225826
Name:LAWSON, TERESA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 TRIPLE CROWN CT
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-7546
Mailing Address - Country:US
Mailing Address - Phone:404-410-2766
Mailing Address - Fax:
Practice Address - Street 1:1001 PONCE DE LEON AVE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-4215
Practice Address - Country:US
Practice Address - Phone:404-898-0360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA21383183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist