Healthcare Provider Details
I. General information
NPI: 1922150531
Provider Name (Legal Business Name): JAWAUN M. LEWIS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/17/2007
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6846 S CANTON AVE STE 230
TULSA OK
74136-3420
US
IV. Provider business mailing address
6846 S CANTON AVE STE 230
TULSA OK
74136-3420
US
V. Phone/Fax
- Phone: 405-541-1146
- Fax: 877-523-7555
- Phone: 405-541-1146
- Fax: 877-523-7555
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | S5213 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 12862 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 05-44564 |
| License Number State | KS |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 2021016109 |
| License Number State | MO |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 4594 |
| License Number State | AL |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | DR.0063239 |
| License Number State | CO |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 6801 |
| License Number State | TN |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | MED-PHYS-LIC-113720 |
| License Number State | MT |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 111759 |
| License Number State | GA |
| # 10 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 4092 |
| License Number State | OK |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 5101029191 |
| License Number State | MI |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 036.179153 |
| License Number State | IL |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | E-12119 |
| License Number State | AR |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 02008927A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
