Basic Information
Provider Information
NPI: 1114910874
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAWLESS
FirstName: JAMES
MiddleName: FRANCIS
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1001 W FAYETTE ST
Address2: SUITE 400
City: SYRACUSE
State: NY
PostalCode: 132042859
CountryCode: US
TelephoneNumber: 3154721488
FaxNumber: 3154728060
Practice Location
Address1: 436 HINSDALE RD
Address2:  
City: CAMILLUS
State: NY
PostalCode: 130311648
CountryCode: US
TelephoneNumber: 3154880996
FaxNumber: 3154881955
Other Information
ProviderEnumerationDate: 08/29/2005
LastUpdateDate: 05/12/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X150733NYY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home