MEDICARE: ALAN G 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	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	14551	OK
2	207X00000X	Orthopaedic Surgery Physician	14551	OK

General Provider Information

NPI Number	:	1366442329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN G LEWIS MD

Provider Business Mailing Address
First Line	:	6475 S YALE AVE
Second Line	:	STE. 301
City	:	TULSA
State	:	OK
Zip	:	74136-7816
Country	:	US
Telephone Number	:	918-494-9300
Fax Number	:	918-494-9324

Provider Business Practice Location Address
First Line	:	6475 S YALE AVE
Second Line	:	STE. 301
City	:	TULSA
State	:	OK
Zip	:	74136-7816
Country	:	US
Telephone Number	:	918-494-9300
Fax Number	:	918-494-9324

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	05/17/2022

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Directions to “ ALAN G LEWIS MD” Practice Location

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