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General NPI Number Information
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NPI Number | 1083690168
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Entity Type | Individual
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Provider Name | JASON LEWIS MD
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Gender | Male
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 4500 SAN PABLO RD S
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City | JACKSONVILLE
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State | FL
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Zip | 32224-1865
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Country | US
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Telephone | 904-953-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 860912
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City | MINNEAPOLIS
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State | MN
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Zip | 55486-0912
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Country | US
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Telephone | 480-301-8000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 78495
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | ME118445
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License Number State | FL
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