Provider Demographics
NPI:1316926959
Name:LAWSON, LIANNA (DO)
Entity type:Individual
Prefix:DR
First Name:LIANNA
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24083-0429
Mailing Address - Country:US
Mailing Address - Phone:540-992-3600
Mailing Address - Fax:540-992-5570
Practice Address - Street 1:12 BOONE DR
Practice Address - Street 2:
Practice Address - City:TROUTVILLE
Practice Address - State:VA
Practice Address - Zip Code:24175-5200
Practice Address - Country:US
Practice Address - Phone:540-992-3600
Practice Address - Fax:540-992-5570
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102050181207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010299004Medicaid
VAP00276997OtherMEDICARE RAILROAD
VA010299004Medicaid
G79381Medicare UPIN