Provider Demographics
NPI:1528783461
Name:LAWSON, KEVIN LEWIS (KPSS)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:LEWIS
Last Name:LAWSON
Suffix:
Gender:M
Credentials:KPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6593 KY 910
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:KY
Mailing Address - Zip Code:42565-6045
Mailing Address - Country:US
Mailing Address - Phone:270-572-0856
Mailing Address - Fax:
Practice Address - Street 1:2735 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:ST CATHARINE
Practice Address - State:KY
Practice Address - Zip Code:40061-9435
Practice Address - Country:US
Practice Address - Phone:833-745-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1204107175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist