Provider Demographics
NPI:1457616039
Name:LAWLER, ELISABETH (MD)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:LAWLER
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 1:2830 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7397
Mailing Address - Country:US
Mailing Address - Phone:541-686-9000
Mailing Address - Fax:541-284-2038
Practice Address - Street 1:2830 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-7397
Practice Address - Country:US
Practice Address - Phone:541-686-9000
Practice Address - Fax:541-284-2038
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD172192207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine