Provider Demographics
NPI:1851544258
Name:LAWSON, PRENTISS JR (MD)
Entity Type:Individual
Prefix:
First Name:PRENTISS
Middle Name:
Last Name:LAWSON
Suffix:JR
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:UAB DEPARTMENT OF ANESTHESIOLOGY
Mailing Address - Street 2:619 19TH STREET S., JT 807
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35249-6810
Mailing Address - Country:US
Mailing Address - Phone:205-934-4696
Mailing Address - Fax:
Practice Address - Street 1:UAB DEPARTMENT OF ANESTHESIOLOGY
Practice Address - Street 2:619 19TH STREET S., JT 807
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-6810
Practice Address - Country:US
Practice Address - Phone:205-934-4696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.29675207LP2900X
AL29675207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OTH001Medicare UPIN
202I729183Medicare PIN