MEDICARE: DR. FLORENCE C. 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	2086S0120X	Pediatric Surgery Physician	J5604	TX
2	2086S0120X	Pediatric Surgery Physician	8950	SD
3	2086S0120X	Pediatric Surgery Physician	41103	IA
4	2086S0120X	Pediatric Surgery Physician	ME89224	FL
5	2086S0120X	Pediatric Surgery Physician	29923	OK

Other Identifiers

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

General Provider Information

NPI Number	:	1811903255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FLORENCE C. LEWIS MD

Provider Business Mailing Address
First Line	:	6600 S YALE AVE
Second Line	:	STE 1200
City	:	TULSA
State	:	OK
Zip	:	74136-3361
Country	:	US
Telephone Number	:	918-488-6687
Fax Number	:	918-488-6098

Provider Business Practice Location Address
First Line	:	6151 S YALE AVE STE 1305
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-1907
Country	:	US
Telephone Number	:	918-494-9450
Fax Number	:	918-494-9437

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	06/30/2021

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