# JAMESTOWN HEALTHCARE CLINIC, LLC

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

## Provider details

- **NPI number:** 1588989008
- **Authorized official:** JERRY W LAWSON M.D. (OWNER, 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 42629-0966
- **Mailing address phone:** (270) 343-2597
- **Mailing address fax:** (270) 343-2598

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 5260P | KY | Yes |

## Other

- **Enumeration date:** 03/29/2010
- **Last updated:** 03/29/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 65944381 | — | KY |