Provider Demographics
NPI:1790869147
Name:LAWSON, JEFFREY GELDERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:GELDERT
Last Name:LAWSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3 SAINT FRANCIS DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-3971
Mailing Address - Country:US
Mailing Address - Phone:864-235-8396
Mailing Address - Fax:864-271-4092
Practice Address - Street 1:3 SAINT FRANCIS DR
Practice Address - Street 2:SUITE 400
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3971
Practice Address - Country:US
Practice Address - Phone:864-235-8396
Practice Address - Fax:864-271-4092
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC9212207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC092125Medicaid
SCD99418Medicare UPIN
SCD994182039Medicare ID - Type Unspecified