Organization
HENRY J. LEWIS, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY J LEWIS III MD (PRESIDENT)
(770) 532-0666
Entity
Organization
Contact information
Practice address
5606 CAPTAINS CT, GAINESVILLE, GA 30504-8197
(770) 532-0666
(770) 532-0666
Mailing address
5606 CAPTAINS CT, GAINESVILLE, GA 30504-8197
(770) 532-0666
(770) 532-0666
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
049052
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000875531B
—
GA
01
—
08BBRBW
MEDICARE P-TAN
GA
01
—
DC0733
RAILROAD MCARE PIN
GA
Enumeration date
10/16/2007
Last updated
10/29/2018
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