Provider Demographics
NPI:1194786681
Name:LAWLESS, DAVID FRANCIS (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:FRANCIS
Last Name:LAWLESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 FERNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-3943
Mailing Address - Country:US
Mailing Address - Phone:814-288-5581
Mailing Address - Fax:814-288-5581
Practice Address - Street 1:551 FERNDALE AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-3943
Practice Address - Country:US
Practice Address - Phone:814-288-5581
Practice Address - Fax:814-288-5581
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019495E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2513634490000OtherCIGNA
210375OtherUPMC
25136344915905A001OtherTRICARE FOR LIFE
17913OtherHEALTH ASSURANCE PA INC
PA0006050370001Medicaid
B36243Medicare UPIN
PA0006050370001Medicaid