Individual
DR. BRACKEN CLAY LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
211 S CHERRY ST, SUITE 2, GREENVILLE, KY 42345-1203
(270) 377-1950
(270) 377-1953
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 377-1950
(270) 377-1953
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
43687
KY
207R00000X
Internal Medicine Physician
LL29141
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100118210
—
KY
Enumeration date
11/01/2006
Last updated
08/21/2015
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