Organization
JACK K LEWIS MD PC
Active
Organization
JACK K LEWIS MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK K LEWIS MD (PRESIDENT)
(402) 393-3616
Entity
Organization
Contact information
Practice address
220 N 89TH ST, SUITE 101, OMAHA, NE 68114-4072
(402) 393-3616
(402) 393-4347
Mailing address
220 N 89TH ST, SUITE 101, OMAHA, NE 68114-4072
(402) 393-3616
(402) 393-4347
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10515
NE
363A00000X
Physician Assistant
778
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026059900
—
NE
Enumeration date
10/18/2006
Last updated
09/09/2013
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