MEDICARE: LYDIA DEE LEWIS MD

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	207V00000X	Obstetrics & Gynecology Physician	15313R	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	841703313	OTHER	LA	BENEFIT MANAGEMENT
2	841703313	OTHER	LA	AETNA
3	H3655	OTHER	LA	BLUE CROSS BLUE SHIELD
4	841703313	OTHER	LA	CIGNA
5	841703313	OTHER	LA	HUMANA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	841703313	OTHER	LA	UNITED HEALTH CARE
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	841703313	OTHER	LA	STATE GROUP
10	841703313	OTHER	LA	FARA
11	841703313	OTHER	LA	COVENTRY
12	841703313	OTHER	LA	TRICARE

General Provider Information

NPI Number	:	1144328535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYDIA DEE LEWIS MD

Provider Business Mailing Address
First Line	:	1514 JEFFERSON HWY
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70121-2429
Country	:	US
Telephone Number	:	504-842-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4845 MAIN ST
Second Line	:	SUITE D
City	:	ZACHARY
State	:	LA
Zip	:	70791-3943
Country	:	US
Telephone Number	:	225-761-5200
Fax Number	:	225-754-5063

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	05/03/2017

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