Individual
KENNETH C LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2460 PATTERSON RD UNIT 4, GRAND JUNCTION, CO 81505-1027
(970) 254-1686
(970) 858-0798
Mailing address
PO BOX 4433, GRAND JUNCTION, CO 81502-4433
(970) 254-1686
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
33466
CO
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
33466
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12650862
—
CO
01
—
LE668943
BLUE CROSS
—
01
—
P00180467
RAILROAD MEDICARE
—
Enumeration date
02/12/2007
Last updated
06/21/2023
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