Organization
M. KEITH LEWIS, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYRON KEITH LEWIS M.D. (OWNER)
(478) 783-2297
Entity
Organization
Contact information
Practice address
292 INDUSTRIAL BLVD, STE. 102, HAWKINSVILLE, GA 31036-8002
(478) 783-2297
(478) 783-2296
Mailing address
292 INDUSTRIAL BLVD, STE. 102, HAWKINSVILLE, GA 31036-8002
(478) 783-2297
(478) 783-2296
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
018922
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP7011
MEDICARE GROUP NUMBER
GA
Enumeration date
07/26/2007
Last updated
07/26/2007
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