Basic Information
| Provider Information | |||||||||
| NPI: | 1467563239 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAWLER | ||||||||
| FirstName: | DOUGLAS | ||||||||
| MiddleName: | REED | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | II | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18377 LAKE RD | ||||||||
| Address2: | |||||||||
| City: | ABINGDON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242115337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2766763150 | ||||||||
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| Practice Location | |||||||||
| Address1: | 351 COURT ST | ||||||||
| Address2: | |||||||||
| City: | ABINGDON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242102921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2766767000 | ||||||||
| FaxNumber: | 2766769366 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 02/04/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 0101042381 | VA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 0101042381 | VA | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 7100150100 | 05 | KY | MEDICAID |