Provider Demographics
NPI:1982003059
Name:LAWSON, BRADLEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:
Last Name:LAWSON
Suffix:
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 1:10901 N RODNEY PARHAM RD
Mailing Address - Street 2:KMART PHARMACY
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-4114
Mailing Address - Country:US
Mailing Address - Phone:501-227-0131
Mailing Address - Fax:501-227-0395
Practice Address - Street 1:10901 N RODNEY PARHAM RD
Practice Address - Street 2:KMART PHARMACY
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-4114
Practice Address - Country:US
Practice Address - Phone:501-227-0131
Practice Address - Fax:501-227-0395
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD11073183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist