Individual
WILLIAM MARK LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEDICAL LN, FOREST, MS 39074-4039
(601) 469-4861
(601) 469-1238
Mailing address
1 MEDICAL LN, FOREST, MS 39074-4039
(601) 469-4861
(601) 469-1238
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
08948
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0116045
—
MS
Enumeration date
09/26/2006
Last updated
07/09/2007
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