Individual
JAMES RIDDELL LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4250 BETHEL RD, OLIVE BRANCH, MS 38654-8737
(901) 516-1290
(901) 516-1220
Mailing address
1211 UNION AVE STE 330, MEMPHIS, TN 38104-6655
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
12853
MS
207R00000X
Internal Medicine Physician
Primary
12853
MS
207R00000X
Internal Medicine Physician
24119
TN
208M00000X
Hospitalist Physician
12853
MS
208M00000X
Hospitalist Physician
24119
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C02394
MEDICARE GROUP
MS
Enumeration date
06/08/2006
Last updated
01/11/2024
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