institution
Charles P. Lawless, M.d., P.a.
Specialist in Pocatello, Idaho
NPI 1629280359

Charles P. Lawless, M.d., P.a. is a Specialist based in Pocatello, ID. Charles P. Lawless, M.d., P.a. practices in Pocatello, ID. The NPI Number for Charles P. Lawless, M.d., P.a. is 1629280359 and holds a License No. M-3434 (Idaho).

The current practice location address for Charles P. Lawless, M.d., P.a. is 1777 E Clark St Ste 310, Pocatello, ID and can be reached out via phone at 208-232-4133 and via fax at 208-233-5736. You can also correspond with Charles P. Lawless, M.d., P.a. through the mailing address at 1777 E CLARK ST STE 310, POCATELLO, ID - 83201-3357 (mailing address contact number: 208-232-4133).

Location: 1777 E Clark St Ste 310, Pocatello, ID, 83201-3357
institution
Provider Profile Details
NPI Number
1629280359
Provider Name
Charles P. Lawless, M.d., P.a.
Credential
Provider Entity Type
Organization
Address
1777 E Clark St Ste 310, Pocatello, ID, 83201-3357
Phone Number
208-232-4133
Fax Number
208-233-5736
Provider Enumeration Date
05/04/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000010005308 01 ID REGENCE BLUE SHIELD OF ID
07302 01 ID BLUE CROSS OF IDAHO
institution
Provider Business Practice Location Address Details
Address
1777 E Clark St Ste 310
City
State
Zip
83201-3357
Phone Number
208-232-4133
Fax Number
208-233-5736
person
Provider Business Mailing Address Details
Address
1777 E Clark St Ste 310
City
State
Zip
83201-3357
Phone Number
208-232-4133
Fax Number
208-233-5736
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
M-3434 (Idaho)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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