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Individual

JUSTIN J LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
141 HOSPITAL DR, STE 102, SALEM, KY 42078-8043
(270) 988-3298
(270) 988-4642
Mailing address
PO BOX 347, SALEM, KY 42078-0347
(270) 988-3298
(270) 988-4642

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
136934
KY
363A00000X
Physician Assistant
Primary
PA2237
KY
363A00000X
Physician Assistant
TC604
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001106789
ANTHEM BLUE CROSS AND BLUE SHIELD OF KY
KY
Enumeration date
05/11/2017
Last updated
04/25/2025
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