Provider Demographics
NPI:1689682486
Name:LAWTON, RODRICK G (MD)
Entity type:Individual
Prefix:DR
First Name:RODRICK
Middle Name:G
Last Name:LAWTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3950 AUSTELL RD
Mailing Address - Street 2:BOX 22
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1121
Mailing Address - Country:US
Mailing Address - Phone:470-732-4022
Mailing Address - Fax:470-732-4023
Practice Address - Street 1:3950 AUSTELL RD
Practice Address - Street 2:BOX 22
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1121
Practice Address - Country:US
Practice Address - Phone:470-732-4022
Practice Address - Fax:470-732-4023
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055766207R00000X
GA55766208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA055766OtherGA LICENSE
GA169171429AMedicaid
GA169171429AMedicaid