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Individual

JOHN GREGORY LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4370 W MAIN ST, DOTHAN, AL 36305
(334) 793-5000
(334) 615-8419
Mailing address
PO BOX 6907, DOTHAN, AL 36302
(334) 793-5000
(334) 615-8419

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0000136709
TN
367500000X
Certified Registered Nurse Anesthetist
1084336
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1772364
LA
01
51526516
BLUE CROSS BLUE SHIELD
AL
Enumeration date
06/07/2006
Last updated
09/11/2025
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