Healthcare Provider Details

I. General information

NPI: 1932305273
Provider Name (Legal Business Name): JULIE C LEW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 EAST STATE ST
ATHENS OH
45701
US

IV. Provider business mailing address

90 JACKSON PIKE
GALLIPOLIS OH
45631-1560
US

V. Phone/Fax

Practice location:
  • Phone: 740-589-3100
  • Fax: 740-592-7342
Mailing address:
  • Phone: 740-589-3100
  • Fax: 740-589-3151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number24226
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35.092596
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: