Individual provider Active NPI

John S Lawall, MD

  • Neurology Physician
  • Tucson, AZ
National Provider Identifier
1760436679
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
7078 Issued in AZ
Practice address
3838 N. Campbell Avenue
Building 2, Clinic E
Tucson, AZ 85719
Phone
(520) 694-8888
Fax
(520) 694-3941
NPI assigned
May 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 7078 AZ Primary

Addresses

Primary practice location

3838 N. Campbell Avenue
Building 2, Clinic E
Tucson, AZ 85719

Mailing address

3838 N. Campbell Avenue
Building 2, Clinic E
Tucson, AZ 85719
Phone (520) 874-3500

Other identifiers 1

IdentifierTypeStateIssuer
262949MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7078AZMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1760436679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 N. CAMPBELL AVENUE",
            "address_2": "BUILDING 2, CLINIC E",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85719",
            "telephone_number": "520-874-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 N. CAMPBELL AVENUE",
            "address_2": "BUILDING 2, CLINIC E",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85719",
            "telephone_number": "520-694-8888",
            "fax_number": "520-694-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWALL",
        "first_name": "JOHN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "7078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262949",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.