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NPI Code Detail

MEDICARE: WILLIAM MARK LEWIS M.D.

MEDICARE: WILLIAM MARK 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
1207Q00000XFamily Medicine Physician08948MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346341054
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM MARK LEWIS M.D.
Provider Business Mailing Address
First Line : 1 MEDICAL LN
Second Line :
City : FOREST
State : MS
Zip : 39074-4039
Country : US
Telephone Number : 601-469-4861
Fax Number : 601-469-1238
Provider Business Practice Location Address
First Line : 1 MEDICAL LN
Second Line :
City : FOREST
State : MS
Zip : 39074-4039
Country : US
Telephone Number : 601-469-4861
Fax Number : 601-469-1238
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 07/09/2007

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