# JAMESTOWN HEALTHCARE CLINIC LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588723241
- **Authorized official:** JERRY WAYNE LAWSON MD (PRESIDENT)
- **Authorized official phone:** (270) 343-2597

## Contact information

- **Practice address:** 1417 N MAIN ST, JAMESTOWN, KY 42629
- **Practice address phone:** (270) 343-2597
- **Practice address fax:** (270) 343-2598
- **Mailing address:** PO BOX 966, JAMESTOWN, KY 42629
- **Mailing address phone:** (270) 343-2597
- **Mailing address fax:** (270) 343-2598

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 33028 | KY | — |
| 207Q00000X | Family Medicine Physician | 37317 | KY | Yes |
| 207Q00000X | Family Medicine Physician | 38782 | KY | — |

## Other

- **Enumeration date:** 12/08/2006
- **Last updated:** 08/22/2020