NPI 1629280359

Charles P. Lawless, M.D., P.A.

Organisation Specialist Pocatello, ID

Practice location

Address: 1777 E Clark St STE 310, Pocatello, ID 83201-3357
Phone: (208) 232-4133
Fax: (208) 233-5736

Authorised official

Name: Charles Pittman Lawless
Title: President
Phone: (208) 232-4133

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence M-3434 (ID)

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Registry record

NPI: 1629280359
Entity type: Organization
NPI issued: 4 May 2007
Record last updated: 3 Dec 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.