Abbott, Jonathan Lawrence

Abbott, Jonathan Lawrence is an individual health care provider with primary practice located at 650 Joel Dr , Fort Campbell KY 42223. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Abbott, Jonathan Lawrence can be contacted via phone (270) 798-8151.

Contact Information

Primary practice address
650 Joel Dr Fort Campbell KY 42223
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 27615 Nebraska
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 52531 Kentucky

Profile Details

NPI number 1730455775
LBN Legal business name Abbott, Jonathan Lawrence
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2012
Last updated Jun 16th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730455775 NPPES
Kentucky MEDICAID 7100610630

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