Organization
KENNETH G. LAWLOR, DO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH GAYLE LAWLOR DO (OWNERPHYSICIAN)
(928) 717-8838
Entity
Organization
Contact information
Practice address
3120 CLEARWATER DR, PRESCOTT, AZ 86305-7131
(928) 717-8838
(928) 717-8832
Mailing address
PO BOX 4343, PRESCOTT, AZ 86302-4343
(928) 717-8838
(928) 717-8832
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
5487
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5487
AZ LIC
AZ
Enumeration date
07/27/2010
Last updated
07/27/2010
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