Organization
LEWIS MEDICAL ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUY LEWIS (OWNER)
(678) 371-0031
Entity
Organization
Contact information
Practice address
4028 HIGHWAY 5, DOUGLASVILLE, GA 30135-3530
(678) 371-0031
Mailing address
284 MOUNT ZION CHURCH RD, WHITESBURG, GA 30185-2342
(678) 371-0031
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN095208NP
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP7342
MEDICARE GROUP NUMBER
GA
Enumeration date
11/12/2007
Last updated
11/15/2007
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