Provider Demographics
NPI:1447276761
Name:LAWTON, JENNIFER S (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:S
Last Name:LAWTON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:C B 8234
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-8008
Mailing Address - Fax:314-747-4871
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:STE 8A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-362-8008
Practice Address - Fax:314-747-4871
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2015-10-30
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Provider Licenses
StateLicense IDTaxonomies
MO2001016823208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO043010412Medicaid
MO043010412Medicaid
MO043010412Medicare PIN
IL$$$$$$$$$Medicaid
MO330005638Medicare PIN