Healthcare Provider Details

I. General information

NPI: 1013259258
Provider Name (Legal Business Name): NICHOLAS WILLIAM LEWING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LALLIE KEMP HOSPITAL
INDEPENDENCE LA
70443
US

IV. Provider business mailing address

2001 CHARVAIS DR
LAKE CHARLES LA
70601-5605
US

V. Phone/Fax

Practice location:
  • Phone: 985-878-9421
  • Fax:
Mailing address:
  • Phone: 225-205-0087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD207376
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: