Provider Demographics
NPI:1023063807
Name:LAWSON, MELISSA A (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:LAWSON
Suffix:
Gender:F
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 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:1020 HITT ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-882-6921
Practice Address - Fax:573-882-1154
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD119697208000000X
MO1196972080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS2086801901OtherKANSAS MEDICAID
MO413884OtherHEALTHLINK
MO128865OtherBLUE SHIELD/BLUE CHOICE
MO204683403Medicaid
MO1201230OtherUNITED HEALTHCARE
MO370014794OtherRR MEDICARE
MO128865OtherBLUE SHIELD/BLUE CHOICE
MO969405236Medicare PIN
MO204683403Medicaid