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General NPI Number Information
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NPI Number | 1326237355
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Entity Type | Organization
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Legal Business Name | HENRY J. LEWIS, MD PC
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 10/29/2018
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Provider Practice Location Address
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Address Line | 5606 CAPTAINS CT
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City | GAINESVILLE
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State | GA
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Zip | 30504-8197
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Country | US
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Telephone | 770-532-0666
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Fax | 770-532-0666
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Provider Business Mailing Address
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Address Line | 5606 CAPTAINS CT
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City | GAINESVILLE
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State | GA
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Zip | 30504-8197
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Country | US
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Telephone | 770-532-0666
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Fax | 770-532-0666
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HENRY J LEWIS III
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Credential | MD
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Telephone | 770-532-0666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 049052
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License Number State | GA
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