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Individual

BRIAN HENRY LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
615 E MAIN ST, JENKS, OK 74037-4138
(918) 299-8080
(918) 298-2838
Mailing address
615 E MAIN ST, JENKS, OK 74037-4138
(918) 299-8080
(918) 298-2838

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4091
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7342704
AETNA
OK
Enumeration date
10/25/2006
Last updated
03/24/2008
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