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Individual

DR. JOHNATHAN W LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
430 MAGNOLIA RD, CAMDEN, AR 71701-4146
(870) 836-5709
(870) 837-2842
Mailing address
430 MAGNOLIA RD, CAMDEN, AR 71701-4146
(870) 836-4709
(870) 836-5837

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E3971
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000252732102
UNITED HEALTH CARE
01
05030029800
QUALCHOICE
AR
05
154567001
AR
01
7165646
AETNA
01
771003001
BREASTCARE
AR
01
P00229512
RAILROAD MEDICARE
Enumeration date
02/24/2006
Last updated
08/27/2024
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