Provider Demographics
NPI:1922093202
Name:MCNARY, LAWSON P JR (MD)
Entity Type:Individual
Prefix:
First Name:LAWSON
Middle Name:P
Last Name:MCNARY
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:PO BOX 629
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71754-0629
Mailing Address - Country:US
Mailing Address - Phone:870-235-3210
Mailing Address - Fax:870-235-3211
Practice Address - Street 1:101 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753
Practice Address - Country:US
Practice Address - Phone:870-235-3210
Practice Address - Fax:870-235-3211
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20050039L208600000X
ARE-5174208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR07050033600OtherQUALCHOICE
AR7105924OtherAETNA
AR165448001Medicaid
AR794727OtherHEALTHLINK
AR7105924OtherAETNA
AR0904380015Medicare NSC
AR794727OtherHEALTHLINK
AR165448001Medicaid
AR5N875Medicare PIN