Individual
JOHN GRANT LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28 JOHN DAVENPORT DR NW, ROME, GA 30165-2536
(706) 232-1503
(706) 235-3684
Mailing address
420 E 2ND AVE, SUITE 103, ROME, GA 30161-3224
(706) 509-3000
(706) 509-4608
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
017028
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00171311J
—
GA
Enumeration date
07/21/2006
Last updated
11/20/2013
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