| 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 |
|---|---|
| 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 |
|---|---|
| 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 | 38782 (Kentucky) | Secondary |
| 207Q00000X | Family Medicine | 37317 (Kentucky) | Primary |
Cumberland Family Medical Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 342 S Main St, Jamestown, KY 42629 Phone: 270-343-3966 Fax: 270-864-1693 | |
Cumberland Family Medical Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Monument Square, Jamestown, KY 42629 Phone: 270-866-3161 | |
Cumberland Family Medical Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1417 N Main Street, Jamestown, KY 42629 Phone: 270-343-2597 Fax: 270-343-2598 |