Organization
JAMESTOWN HEALTHCARE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY W LAWSON M.D. (OWNER, 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 42629-0966
(270) 343-2597
(270) 343-2598
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5260P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65944381
—
KY
Enumeration date
03/29/2010
Last updated
03/29/2010
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