Individual
LEWIS JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
111 N HUBBARDS LN STE 1, LOUISVILLE, KY 40207-3902
(859) 475-2184
Mailing address
111 N HUBBARDS LN STE 1, LOUISVILLE, KY 40207-3902
(859) 475-2184
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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