Provider Demographics
NPI:1780615633
Name:LAWSON, NATHANIEL O (MD)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:O
Last Name:LAWSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:135 BRIDGEWATER XING
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-8602
Mailing Address - Country:US
Mailing Address - Phone:601-594-6934
Mailing Address - Fax:601-853-7623
Practice Address - Street 1:135 BRIDGEWATER XING
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-8602
Practice Address - Country:US
Practice Address - Phone:601-594-6934
Practice Address - Fax:601-853-7623
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2016-03-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS159582084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0121949Medicaid
SC391007Medicaid
SC391007Medicaid
MS0121949Medicaid