Individual
DR. JAY PATRICK LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
8300 CONSTITUTION AVE NE BLDG D, ALBUQUERQUE, NM 87110
(505) 253-6100
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD2024-0001
NM
Other
Enumeration date
06/08/2020
Last updated
10/07/2024
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