Healthcare Provider Details

I. General information

NPI: 1508981663
Provider Name (Legal Business Name): KATHLEEN M LEWISON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 04/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 HOSPITAL WAY
WHITEFISH MT
59937-7858
US

IV. Provider business mailing address

2002 HOSPITAL WAY
WHITEFISH MT
59937-7858
US

V. Phone/Fax

Practice location:
  • Phone: 406-862-6436
  • Fax: 406-862-9978
Mailing address:
  • Phone: 406-862-6436
  • Fax: 406-862-9978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number97-00636
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number11793
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number46424
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number11793
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: