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General NPI Number Information
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NPI Number | 1548538002
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Entity Type | Organization
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Legal Business Name | LEWIS HARGETT MD PSC
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Dates
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Enumeration Date | 12/12/2011
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Last Update Date | 12/12/2011
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Provider Practice Location Address
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Address Line | 1900 BLUEGRASS AVE STE 100
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City | LOUISVILLE
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State | KY
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Zip | 40215-1144
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Country | US
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Telephone | 502-366-8021
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Fax | 502-366-8235
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Provider Business Mailing Address
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Address Line | 1900 BLUEGRASS AVE STE 100
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City | LOUISVILLE
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State | KY
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Zip | 40215-1144
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Country | US
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Telephone | 502-366-8021
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Fax | 502-366-8235
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Authorized Official
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Title or Position | PHYISICAN
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Name | LEWIS HARGETT
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Credential | MD
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Telephone | 502-366-8021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 01038361A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | KY26076
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License Number State | KY
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