Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 4193 | SD |
NPI | 1063403848 |
---|---|
Provider Name | Dr. Brett D Lawlor |
First Address | Rapid City, SD 57702-4335 |
Second Address | Rapid City, SD 57702-4335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 10/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0006333 | WELLMARK BCBS (01) | SD |
1063403848 | (05) | SD |
115322600 | WYOMING MEDICAID (01) | SD |
13327600 | WYOMING MEDICAID (01) | SD |
2300560 | MEDICA (01) | SD |
31783 | SANDFORD HEALTH PLAN (01) | SD |
31783 | SANFORD HEALTH PLAN (01) | SD |
41194500700 | NEBRASKA MEDICAID (01) | SD |
4193 | DAKOTACARE (01) | SD |
F59481 | (02) | SD |