Provider Demographics
NPI:1811083785
Name:LAWSON, LOUISA EMEFA (MD)
Entity type:Individual
Prefix:
First Name:LOUISA
Middle Name:EMEFA
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 1:361 INDIAN GATE CIR
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-8704
Mailing Address - Country:US
Mailing Address - Phone:601-924-2008
Mailing Address - Fax:601-924-2022
Practice Address - Street 1:210 CLINTON BLVD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-5126
Practice Address - Country:US
Practice Address - Phone:601-924-2008
Practice Address - Fax:601-924-2022
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS14149208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSF99933Medicare UPIN
MS00116332Medicare ID - Type Unspecified