Individual
MR. MARK ALLAN LAWSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
550 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 758-3793
Mailing address
550 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 758-3793
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1053751
—
363A00000X
Physician Assistant
15-01189
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053751
NCCPA
—
01
—
15-01189
STATE PA LICENSE
KS
Enumeration date
12/15/2005
Last updated
01/11/2024
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