Provider Demographics
NPI:1063428753
Name:LAWTON, MICHAEL W (ARNP)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:W
Last Name:LAWTON
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8333 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6050
Mailing Address - Country:US
Mailing Address - Phone:850-969-7979
Mailing Address - Fax:850-476-9200
Practice Address - Street 1:8333 NORTH DAVIS HIGHWAY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514
Practice Address - Country:US
Practice Address - Phone:850-969-7979
Practice Address - Fax:850-476-9200
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2980612363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00372406OtherRAILROAD MEDICARE
FL301647100Medicaid
FLY6918XMedicare PIN
FLY6918YMedicare PIN
FLP00372406OtherRAILROAD MEDICARE
FLS57402Medicare UPIN