Organization
JAMESTOWN HEALTHCARE CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY WAYNE LAWSON MD (PRESIDENT)
(270) 343-2597
Entity
Organization
Contact information
Practice address
1417 N MAIN ST, JAMESTOWN, KY 42629
(270) 343-2597
(270) 343-2598
Mailing address
PO BOX 966, JAMESTOWN, KY 42629
(270) 343-2597
(270) 343-2598
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
33028
KY
207Q00000X
Family Medicine Physician
Primary
37317
KY
207Q00000X
Family Medicine Physician
38782
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326046913
JERRY W LAWSON MD NPI
—
01
—
1396746533
STEPHANIE R JONES MD NPI
—
01
—
1821096421
THOMAS D JOHNSON MD NPI
—
05
—
64048283
—
KY
05
—
64072168
—
KY
05
—
64330285
—
KY
01
—
65944381
MC GROUP #
—
01
—
9872
MC GROUP #
—
Enumeration date
12/08/2006
Last updated
08/22/2020
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