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Individual

DR. PENNY JO LAWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 354-4488
(601) 914-1852
Mailing address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 354-4488
(601) 914-1852

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
16291
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00121159
MS
01
200035795
MEDICARE RR
MS
Enumeration date
10/11/2005
Last updated
11/17/2011
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