Healthcare Provider Details

I. General information

NPI: 1801961107
Provider Name (Legal Business Name): AARON PRESTON LEWIS PA - C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2479 S CLERMONT ST
DENVER CO
80222-6588
US

IV. Provider business mailing address

PO BOX 40128
DENVER CO
80204-0128
US

V. Phone/Fax

Practice location:
  • Phone: 973-661-8300
  • Fax: 973-661-8333
Mailing address:
  • Phone: 720-277-9290
  • Fax: 877-319-1589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA-2362
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: