Provider Demographics
NPI:1841834272
Name:ELISABETH J LAWSON LLC
Entity type:Organization
Organization Name:ELISABETH J LAWSON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-292-9015
Mailing Address - Street 1:1525 MARKET PLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7935
Mailing Address - Country:US
Mailing Address - Phone:770-292-9015
Mailing Address - Fax:
Practice Address - Street 1:1525 MARKET PLACE BLVD
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7935
Practice Address - Country:US
Practice Address - Phone:770-292-9015
Practice Address - Fax:678-513-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-29
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty