Healthcare Provider Details

I. General information

NPI: 1982873576
Provider Name (Legal Business Name): LEWIS WHITMAN HOVATER JR. NURSE ANESTHETIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 06/22/2020
Certification Date: 06/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 7TH STREET SE
DECATUR AL
35609-2239
US

IV. Provider business mailing address

PO BOX 2239
DECATUR AL
35609-2239
US

V. Phone/Fax

Practice location:
  • Phone: 256-341-2000
  • Fax:
Mailing address:
  • Phone: 256-341-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-027033
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: