Provider Demographics
NPI:1235721028
Name:LAWSON, JONATHAN RAY (CPHT)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:RAY
Last Name:LAWSON
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2327 HIGHWAY 3345
Mailing Address - Street 2:
Mailing Address - City:EZEL
Mailing Address - State:KY
Mailing Address - Zip Code:41425-8967
Mailing Address - Country:US
Mailing Address - Phone:606-359-1967
Mailing Address - Fax:
Practice Address - Street 1:275 PRESTONSBURG ST
Practice Address - Street 2:
Practice Address - City:WEST LIBERTY
Practice Address - State:KY
Practice Address - Zip Code:41472-1135
Practice Address - Country:US
Practice Address - Phone:606-743-3425
Practice Address - Fax:606-743-1936
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician