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NPI Code Detail

MEDICARE: CLINTON ALLEN LEWIS PSYD

MEDICARE: CLINTON ALLEN LEWIS PSYD
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
1103T00000XPsychologist896OK

General Provider Information

NPI Number : 1316957624
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLINTON ALLEN LEWIS PSYD
Provider Business Mailing Address
First Line : 3000 W MEMORIAL RD STE 218
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73120-6103
Country : US
Telephone Number : 405-286-2977
Fax Number :
Provider Business Practice Location Address
First Line : 3000 W MEMORIAL RD STE 218
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73120-6103
Country : US
Telephone Number : 405-286-2977
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2006
Last Update Date : 12/02/2025

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Directions to “ CLINTON ALLEN LEWIS PSYD” Practice Location

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