Individual
GREGORY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7501 RIVERSIDE PKWY, TULSA, OK 74136-5056
(918) 710-4208
Mailing address
7600 S LEWIS AVE, TULSA, OK 74136-6836
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28635
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2011
Last updated
08/19/2019
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