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NPI Code Detail

MEDICARE: WILLIAM D LEWIS MD

MEDICARE: WILLIAM D 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
12085R0202XDiagnostic Radiology Physician34950KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000341153OTHERKYBC/BS INDIVIDUAL PIN NO
3P00145367OTHERKYRR MDCR INDIVIDUAL PIN NO

General Provider Information

NPI Number : 1679573471
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM D LEWIS MD
Provider Business Mailing Address
First Line : PO BOX 766
Second Line :
City : MOREHEAD
State : KY
Zip : 40351-0766
Country : US
Telephone Number : 866-871-7657
Fax Number :
Provider Business Practice Location Address
First Line : 222 MEDICAL CIR
Second Line :
City : MOREHEAD
State : KY
Zip : 40351-1179
Country : US
Telephone Number : 606-783-6500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2005
Last Update Date : 07/09/2007

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