Individual
DR. FREDRICK AUSTIN LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 PIN OAK LN, HAMMOND, LA 70401-8201
(985) 429-8412
Mailing address
22 PIN OAK LN, HAMMOND, LA 70401-8201
(985) 429-8412
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
010125
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1110124
—
LA
Enumeration date
05/02/2007
Last updated
07/08/2007
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