Individual
JASON LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3125 S SCATTERFIELD RD STE 300, ANDERSON, IN 46013-1803
(765) 298-4630
(765) 298-4901
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01070104A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201067400
—
IN
01
—
P01157055
RR MEDICARE PTAN
IN
Enumeration date
04/17/2009
Last updated
02/11/2026
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