Provider Demographics
NPI:1114092921
Name:LAWHON, JEFFREY C (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:C
Last Name:LAWHON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 N DUNCAN ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38556-3100
Mailing Address - Country:US
Mailing Address - Phone:931-879-6293
Mailing Address - Fax:931-879-9007
Practice Address - Street 1:114 N DUNCAN ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556-3100
Practice Address - Country:US
Practice Address - Phone:931-879-6293
Practice Address - Fax:931-879-9007
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-01694208600000X
TNMD31029208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5916022Medicaid
NC5916022Medicaid
NC5916022Medicaid
NC15994OtherBCBSNC