Provider Demographics
NPI:1922093350
Name:LAWHEAD, RAYMOND A JR (MD)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:A
Last Name:LAWHEAD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2675 N DECATUR RD
Mailing Address - Street 2:STE# 408
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6131
Mailing Address - Country:US
Mailing Address - Phone:404-501-7100
Mailing Address - Fax:404-501-7105
Practice Address - Street 1:2675 N DECATUR RD
Practice Address - Street 2:STE# 408
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6131
Practice Address - Country:US
Practice Address - Phone:404-501-7100
Practice Address - Fax:404-501-7105
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA027853207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA98BBBCDMedicare ID - Type Unspecified
GAD30024Medicare UPIN