Provider Demographics
NPI:1720016884
Name:LAWS, JAMES GENTRY (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:GENTRY
Last Name:LAWS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W GRAND AVE
Mailing Address - Street 2:SUITE 2002
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-4775
Mailing Address - Country:US
Mailing Address - Phone:937-277-8326
Mailing Address - Fax:937-277-8404
Practice Address - Street 1:425 W GRAND AVE
Practice Address - Street 2:SUITE 2002
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-4775
Practice Address - Country:US
Practice Address - Phone:937-277-8326
Practice Address - Fax:937-277-8404
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-2048-L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0281627Medicaid
OH0281627Medicaid
LA0410223Medicare ID - Type Unspecified