Individual
MIRANDA GAYLE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2225 US HIGHWAY 41 N, TIFTON, GA 31794-2749
(229) 391-4100
Mailing address
2225 US HIGHWAY 41 N, TIFTON, GA 31794-2749
(229) 391-4100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10825
GA
Other
Enumeration date
01/03/2022
Last updated
08/22/2023
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