# JOHNATHAN LEWIS MD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Lewis Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265047187
- **Authorized official:** JOHNATHAN LEWIS MD (OWNER)
- **Authorized official phone:** (870) 836-5709

## Contact information

- **Practice address:** 430 MAGNOLIA RD, CAMDEN, AR 71701-4146
- **Practice address phone:** (870) 836-5709
- **Practice address fax:** (870) 836-5837
- **Mailing address:** 430 MAGNOLIA RD, CAMDEN, AR 71701-4146
- **Mailing address phone:** (870) 836-5709
- **Mailing address fax:** (870) 837-2842

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 09/09/2020
- **Last updated:** 08/27/2024