Individual
JACOB OGDEN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
850 6TH ST, LOVELOCK, NV 89419-8020
(775) 273-2918
(775) 273-5095
Mailing address
PO BOX 661, LOVELOCK, NV 89419-0661
(775) 273-2621
(775) 273-5095
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/02/2019
Last updated
06/26/2024
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