Individual
MR. PHILLIP E LEWELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1995 E OAKLAND PARK BLVD, FT LAUDERDALE, FL 33306-1147
(954) 791-6146
(954) 337-2733
Mailing address
2011 MURPHY AVE, SUITE 408, NASHVILLE, TN 37203-2023
(615) 327-1515
(615) 352-1428
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
551
TN
363AS0400X
Surgical Physician Assistant
Primary
551
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3666998
—
TN
01
—
4071394
BCBS
TN
Enumeration date
11/04/2005
Last updated
03/13/2019
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