Individual
JANE P. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1558 S MAIN ST, MCALESTER, OK 74501-7036
(918) 426-0900
Mailing address
5031 CARL ALBERT RD., MCALESTER, OK 74501
(918) 423-1272
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
679
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100226780A
—
OK
Enumeration date
10/25/2005
Last updated
12/06/2010
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