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General NPI Number Information
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NPI Number | 1194079129
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Entity Type | Individual
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Provider Name | BOBBY WAYNE LEWIS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/29/2012
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Last Update Date | 10/29/2012
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Provider Practice Location Address
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Address Line | 2103 E ANDREW JOHNSON HWY
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City | MORRISTOWN
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State | TN
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Zip | 37814-5411
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Country | US
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Telephone | 423-586-5058
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Fax |
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Provider Business Mailing Address
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Address Line | 214 NEALS LANDING RD
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City | KNOXVILLE
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State | TN
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Zip | 37924-3858
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Country | US
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Telephone | 865-250-3664
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0000036759
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License Number State | TN
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