Individual
SANDRA L LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
31870 E. HIGHWAY 51, COWETA, OK 74429
(918) 279-3200
(918) 756-3993
Mailing address
PO BOX 400, OKMULGEE, OK 74447-0400
(918) 756-3334
(918) 756-3993
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
656
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1600656
—
OK
Enumeration date
07/07/2006
Last updated
07/09/2007
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