Individual
DR. BENJAMIN R LAWLESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4550 COBB PARKWAY NORTH NW STE 101, ACWORTH, GA 30101
(470) 956-0100
(770) 529-0279
Mailing address
805 SANDY PLAINS ROAD, MEDICAL STAFF SERVICES, MARIETTA, GA 30066-6340
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
22658
SC
207Q00000X
Family Medicine Physician
Primary
69843
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
428958
RURAL HEALTH/ CMS
SC
01
—
PENDING
RRMED
VA
05
—
RHC132
—
SC
Enumeration date
11/29/2005
Last updated
10/31/2019
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