Provider Demographics
NPI:1932169562
Name:LAWSON, ROBERT W (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:LAWSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S MOHAWK DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:ERWIN
Mailing Address - State:TN
Mailing Address - Zip Code:37650-2124
Mailing Address - Country:US
Mailing Address - Phone:423-330-6177
Mailing Address - Fax:423-330-6241
Practice Address - Street 1:800 S MOHAWK DR
Practice Address - Street 2:SUITE E
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650-2124
Practice Address - Country:US
Practice Address - Phone:423-330-6177
Practice Address - Fax:423-330-6241
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD9351207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3167404Medicaid
TN3167404Medicare PIN
TNB03230Medicare UPIN
TN3167404Medicaid