Provider Demographics
NPI:1790958288
Name:LAWSON, JOHN PAUL JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:LAWSON
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 N ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:BONNE TERRE
Mailing Address - State:MO
Mailing Address - Zip Code:63628-1210
Mailing Address - Country:US
Mailing Address - Phone:573-358-3311
Mailing Address - Fax:573-358-7971
Practice Address - Street 1:36 N ALLEN ST
Practice Address - Street 2:
Practice Address - City:BONNE TERRE
Practice Address - State:MO
Practice Address - Zip Code:63628-1210
Practice Address - Country:US
Practice Address - Phone:573-358-3311
Practice Address - Fax:573-358-7971
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005007709183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2005007709OtherPHARMACIST LICENSE