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General NPI Number Information
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NPI Number | 1619850005
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Entity Type | Individual
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Provider Name | JOSEPH ANTHONY LEWIS II FNP-C
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Gender | Male
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 101 QUARTZ DR STE 11
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City | VILLA RICA
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State | GA
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Zip | 30180-3255
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Country | US
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Telephone | 770-836-9445
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Fax | 770-836-8808
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Provider Business Mailing Address
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Address Line | 118 SPRINGWOOD DR
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City | CARROLLTON
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State | GA
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Zip | 30117-3039
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Country | US
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Telephone | 470-764-8966
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-NP297285
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License Number State | GA
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