Individual
ROMAN T LEWICKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1485 N TURQUOISE DR, SUITE 200, FLAGSTAFF, AZ 86001-1398
(928) 774-7757
(928) 774-7767
Mailing address
4711 N VESELKA RANCH RD, FLAGSTAFF, AZ 86001-9341
(928) 774-7757
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
8674
AZ
207X00000X
Orthopaedic Surgery Physician
8674
AZ
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
8674
AZ
Other
Enumeration date
02/01/2006
Last updated
03/02/2010
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