Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 1902 | MA |
NPI | 1346263381 |
---|---|
Provider Name | Kenneth Allan Lawton |
First Address | Brookline, MA 02446-2215 |
Second Address | Brookline, MA 02446-2215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 13/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0362905 | (05) | MA |
T84982 | (02) | MA |