Individual
DR. DEREK LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6209 W 12TH ST, LITTLE ROCK, AR 72204-1505
(501) 663-5221
(501) 663-6759
Mailing address
6209 W 12TH ST, LITTLE ROCK, AR 72204-1505
(501) 663-5221
(501) 663-6759
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C6631
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110711001
—
AR
Enumeration date
04/14/2006
Last updated
08/02/2010
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