MEDICARE: DR. JOYCE ROCHELLE LEWIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	041874	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	AETNA	OTHER		5790459
3	0101285	OTHER		UNITED HEALTHCARE
4	1036625-300	OTHER		FIRST HEALTH
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	0864145006	OTHER		CIGNA
7	1215932751	OTHER	GA	GROUP NP
8	21149336803	OTHER		BEECHSTREET
9	52508065-003	OTHER		BLUE CROSS BLUE SHIELD
10	588779	OTHER		AETNA

General Provider Information

NPI Number	:	1043214737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOYCE ROCHELLE LEWIS M.D.

Provider Business Mailing Address
First Line	:	3700 MARKET ST
Second Line	:	STE C
City	:	CLARKSTON
State	:	GA
Zip	:	30021-2652
Country	:	US
Telephone Number	:	404-298-9333
Fax Number	:	404-298-9931

Provider Business Practice Location Address
First Line	:	3700 MARKET ST
Second Line	:	STE C
City	:	CLARKSTON
State	:	GA
Zip	:	30021-2652
Country	:	US
Telephone Number	:	404-298-9333
Fax Number	:	404-298-9931

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	12/23/2014

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