Organization
KENNETH C. LEWIS MD,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH LEWIS MD (OWNER)
(970) 254-1686
Entity
Organization
Contact information
Practice address
2460 PATTERSON RD UNIT 4, GRAND JUNCTION, CO 81505-1027
(970) 254-1686
Mailing address
PO BOX 4433, GRAND JUNCTION, CO 81502-4433
(970) 254-1686
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09702377
—
CO
01
—
DC6242
RAIL ROAD MEDICARE
—
Enumeration date
02/12/2007
Last updated
06/21/2023
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