Individual
MR. MARC LAWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
1400 N 500 E, LOGAN, UT 84341-2455
(435) 753-1382
Mailing address
665 EAGLEVIEW CT, PROVIDENCE, UT 84332-9224
(435) 232-2537
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
348763-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005592414
MCR
UT
01
—
11/10/1974
DOB
UT
01
—
1285756825
NPI
UT
01
—
53699191200001
BCBS
UT
Enumeration date
04/04/2007
Last updated
05/11/2026
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