Individual
REGINA MARIE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2345 SOUTHWEST BLVD, TULSA, OK 74107-2705
(918) 582-1980
(918) 561-1289
Mailing address
2345 SOUTHWEST BLVD, TULSA, OK 74107-2705
(918) 582-1980
(918) 561-1289
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4093
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200090340A
—
OK
01
—
248722808
MEDICARE
OK
Enumeration date
08/04/2006
Last updated
02/12/2019
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