Individual
ADAM LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6051 U S HIGHWAY 49, HATTIESBURG, MS 39401-7200
(601) 288-2690
Mailing address
22 ASHBOROUGH LN, HATTIESBURG, MS 39402-6100
(601) 335-3113
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
363A00000X
Physician Assistant
PA00597
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1111054882
U.S. ARMY
—
Enumeration date
10/10/2019
Last updated
10/05/2021
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