Provider Demographics
NPI:1104258367
Name:LAWSON, TRACY LEE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:LEE
Last Name:LAWSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5462 DR THOMAS WALKER RD
Mailing Address - Street 2:
Mailing Address - City:ROSE HILL
Mailing Address - State:VA
Mailing Address - Zip Code:24281-8360
Mailing Address - Country:US
Mailing Address - Phone:276-445-5026
Mailing Address - Fax:276-445-5029
Practice Address - Street 1:5462 DR THOMAS WALKER RD
Practice Address - Street 2:
Practice Address - City:ROSE HILL
Practice Address - State:VA
Practice Address - Zip Code:24281-8360
Practice Address - Country:US
Practice Address - Phone:276-445-5026
Practice Address - Fax:276-445-5029
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202205627183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist