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Individual

DR. GARY LEE LEWIS

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
1430 W 1ST ST N, PRESCOTT, AR 71857-3339
(870) 887-2717
(870) 887-2113
Mailing address
1941 NEVADA 23, PRESCOTT, AR 71857-7008
(870) 887-5857
(870) 887-2113

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
05910
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05910
PHARMACIST LICENSE
AR
Enumeration date
09/23/2005
Last updated
07/08/2007
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