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Individual

DR. KENT TALMAGE LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3331 E BASELINE RD, GILBERT, AZ 85234-2633
(480) 545-1100
(480) 545-7181
Mailing address
PO BOX 7060, CHANDLER, AZ 85246-7060
(480) 444-2017
(480) 545-7181

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3462
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1Z0862
HEALTH NET AZ
AZ
05
482331001
AZ
01
AZ0891420
BCBS
AZ
Enumeration date
05/18/2006
Last updated
11/15/2017
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