Individual
DR. JASON CARNES LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 S 1ST ST, SUITE 300, LOUISVILLE, KY 40202-5404
(502) 855-3919
(502) 855-3920
Mailing address
PO BOX 21890, BELFAST, ME 04915-4115
(502) 907-0356
(502) 907-0356
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
42621
KY
207LP2900X
Pain Medicine (Anesthesiology) Physician
01072411A
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
42621
KY
208VP0014X
Interventional Pain Medicine Physician
42621
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000825810
ANTHEM PROVIDER ID NUMBER
—
01
—
005625439
UNITED HEALTHCARE PROVIDER ID NUMBER
—
05
—
200955190
—
IN
05
—
7100080620
—
KY
01
—
84129KYIP
AETNA BETTER HEALTH OF KY PROVIDER ID NUMBER
KY
01
—
9497399
AETNA PIN NUMBER
—
01
—
961015
WELLCARE OF KY PROVIDER ID NUMBER
KY
01
—
CS1425100206
CARESOURCE PROVIDER ID NUMBER
—
Enumeration date
02/05/2007
Last updated
09/12/2024
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