Healthcare Provider Details

I. General information

NPI: 1790869147
Provider Name (Legal Business Name): JEFFREY GELDERT LAWSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 12/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 SAINT FRANCIS DR SUITE 400
GREENVILLE SC
29601-3971
US

IV. Provider business mailing address

3 SAINT FRANCIS DR SUITE 400
GREENVILLE SC
29601-3971
US

V. Phone/Fax

Practice location:
  • Phone: 864-235-8396
  • Fax: 864-271-4092
Mailing address:
  • Phone: 864-235-8396
  • Fax: 864-271-4092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number9212
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: