Individual
MR. LANCELOT D. LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
OFF HWY 191 HOSPITAL ROAD, CHINLE, AZ 86503
(928) 674-7001
(928) 674-7705
Mailing address
PO DRAWER PH, CHINLE, AZ 86503
(928) 674-7001
(928) 674-7705
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1952
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
547242
—
AZ
Enumeration date
03/20/2007
Last updated
07/09/2007
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