Basic Information
| Provider Information | |||||||||
| NPI: | 1215116025 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAWSON | ||||||||
| FirstName: | RONG | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | ALPENA MEDICAL ARTS, PC | ||||||||
| Address2: | 211 LONG RAPIDS ROAD | ||||||||
| City: | ALPENA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9893584251 | ||||||||
| FaxNumber: | 9893548600 | ||||||||
| Practice Location | |||||||||
| Address1: | ALPENA MEDICAL ARTS, PC | ||||||||
| Address2: | 211 LONG RAPIDS ROAD | ||||||||
| City: | ALPENA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9893584251 | ||||||||
| FaxNumber: | 9893548600 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2007 | ||||||||
| LastUpdateDate: | 02/10/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | RL10609 | ND | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1215116025 | 01 | MI | NPI | OTHER | 12083 | 05 | ND | MEDICAID |