Individual
PATRICK TARRANCE LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1850 CHADWICK DR, JACKSON, MS 39204-3404
(601) 376-1000
Mailing address
203 RESERVE DR, CLINTON, MS 39056-5985
(971) 998-2713
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/26/2022
Last updated
12/26/2022
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