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Individual

MRS. ANGELA DAWN LEWIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1021 KENWOOD DR, RUSSELL, KY 41169
(606) 836-1954
(606) 836-3878
Mailing address
1021 KENWOOD DR, RUSSELL, KY 41169
(606) 836-1954
(606) 836-3878

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
KY02545
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080127343
RAILROAD MEDICARE
KY
05
64025455
KY
Enumeration date
10/05/2006
Last updated
01/05/2011
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