Individual
DR. KENNETH GAYLE LAWLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3111 CLEARWATER DR STE A, PRESCOTT, AZ 86305-7186
(480) 443-8400
(480) 443-8697
Mailing address
4550 E BELL RD, SUITE 172, PHOENIX, AZ 85032-9306
(480) 443-8400
(480) 443-8697
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
2007015085
MO
207RR0500X
Rheumatology Physician
Primary
5487
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801100250
GROUP NATIONAL PROVIDER IDENTIFIER
AZ
05
—
546714
—
AZ
Enumeration date
08/31/2006
Last updated
04/18/2016
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