Individual
LUCIUS LEWIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1970 HOSPITAL DR, CLARKSDALE, MS 38614-7202
(662) 624-3401
(662) 627-5440
Mailing address
103 THORNWOOD DR, CLINTON, MS 39056-6226
(662) 588-0277
(804) 545-0652
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R868756
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04225557
—
MS
Enumeration date
11/20/2006
Last updated
09/04/2013
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