Jamestown Healthcare Clinic Llc | |
1417 N Main St Jamestown KY 42629 | |
(270) 343-2597 | |
(270) 343-2598 |
Full Name | Jamestown Healthcare Clinic Llc |
---|---|
Speciality | Family Medicine |
Location | 1417 N Main St, Jamestown, Kentucky |
Authorized Official Name and Position | Jerry Wayne Lawson (PRESIDENT) |
Authorized Official Contact | 2703432597 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Jamestown Healthcare Clinic Llc Po Box 966 Jamestown KY 42629 Ph: (270) 343-2597 | Jamestown Healthcare Clinic Llc 1417 N Main St Jamestown KY 42629 Ph: (270) 343-2597 |
NPI Number | 1588723241 |
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Provider Enumeration Date | 12/08/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588723241 | NPI | - | NPPES |
65944381 | Other | MC GROUP # | |
64072168 | Medicaid | KY | |
1326046913 | Other | JERRY W LAWSON MD NPI | |
1396746533 | Other | STEPHANIE R JONES MD NPI | |
9872 | Other | MC GROUP # | |
64330285 | Medicaid | KY | |
1821096421 | Other | THOMAS D JOHNSON MD NPI | |
64048283 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 33028 (Kentucky) | Secondary |
207Q00000X | Family Medicine | 37317 (Kentucky) | Primary |
207Q00000X | Family Medicine | 38782 (Kentucky) | Secondary |
Jamestown Elementary Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 342 S Main St, Jamestown, KY 42629 Phone: 270-343-3966 Fax: 270-864-1693 | |
Jamestown Family Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1417 N Main Street, Jamestown, KY 42629 Phone: 270-343-2597 Fax: 270-343-2598 |