Individual
DR. LARRY JOE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
14975 BYPASS ST, CHOCTAW, OK 73020-8504
(405) 390-9106
(405) 390-1105
Mailing address
14975 BYPASS ST, CHOCTAW, OK 73020-8504
(405) 390-9106
(405) 390-1105
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
768
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1317550002
PALMETTO GBA DMERC
OK
Enumeration date
07/29/2005
Last updated
01/24/2008
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