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Individual

DEIRDRE MAE CLAIREWEN LAWSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
235 WALNUT STREET, LEESBURG, GA 31763
(229) 759-6508
(229) 759-9950
Mailing address
204 N WESTOVER BLVD, ALBANY, GA 31707-2983
(229) 888-6559
(229) 436-4107

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036649
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000608858A
GA
05
000608858F
GA
01
110087556
RR MCARE - EAMC
GA
01
110087557
RR MCARE - LMAC
GA
01
497273
BCBS - EAMC
GA
01
497274
BCBS - LMAC
GA
01
5933590
AETNA
GA
Enumeration date
09/07/2006
Last updated
11/29/2011
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