Provider Demographics
NPI:1942412333
Name:LAWSON, LYNESE L (DO)
Entity type:Individual
Prefix:DR
First Name:LYNESE
Middle Name:L
Last Name:LAWSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6271 SHACKELFORD TER
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-1728
Mailing Address - Country:US
Mailing Address - Phone:703-774-4869
Mailing Address - Fax:888-205-7932
Practice Address - Street 1:2104 GALLOWS RD
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3929
Practice Address - Country:US
Practice Address - Phone:703-822-5003
Practice Address - Fax:888-205-7932
Is Sole Proprietor?:No
Enumeration Date:2007-05-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAE80776Medicare UPIN