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Individual

JONATHAN ADAM LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
610 E BRANNON RD, NICHOLASVILLE, KY 40356-6066
(859) 260-5540
(859) 260-4399
Mailing address
PO BOX 950138, LOUISVILLE, KY 40295-0138
(502) 489-5730
(502) 489-5753

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
39542
TN
207Q00000X
Family Medicine Physician
Primary
40193
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1437198645
VA
05
3330555
TN
Enumeration date
06/05/2006
Last updated
12/08/2020
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