Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 23468 | AZ |
N | 207T00000X | Neurosurgeon | A62104 | CA |
NPI | 1073562294 |
---|---|
Provider Name | Dr. Michael T Lawton |
First Address | Phoenix, AZ 85013-4434 |
Second Address | Phoenix, AZ 85013-4434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2006 |
Last Update Date | 11/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
896384 | (05) | AZ |