Provider Demographics
NPI:1194799494
Name:LAWTON, DAVID (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:LAWTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 OLEAN ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2540
Mailing Address - Country:US
Mailing Address - Phone:716-805-1072
Mailing Address - Fax:716-805-1073
Practice Address - Street 1:112 OLEAN ST
Practice Address - Street 2:SUITE 220
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-2540
Practice Address - Country:US
Practice Address - Phone:716-805-1072
Practice Address - Fax:716-805-1073
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY191961207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY080191946OtherRAILROAD MEDICARE
NY00010100603OtherUNIVERA
NY0106410OtherIHA
NY040426002653OtherFIDELIS
NY000523366006OtherBC/BS
NY191961OtherLICENSE
NY01787315Medicaid
NY148852BFOtherPREFERRED CARE
NYCK7008OtherRAILROAD MEDICARE
NY040426002653OtherFIDELIS
NY0106410OtherIHA
NY01787315Medicaid