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General NPI Number Information
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NPI Number | 1629364534
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Entity Type | Individual
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Provider Name | CLAYTON LEWIS M.D
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Gender | Male
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 2222 N NEVADA AVE STE 5017
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-6865
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Country | US
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Telephone | 719-776-6810
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Fax | 719-776-6820
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Provider Business Mailing Address
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Address Line | 1650 COCHRANE CIR UNIT MEDDAC
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City | FORT CARSON
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State | CO
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Zip | 80913-4604
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Country | US
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Telephone | 719-524-4166
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Fax | 719-524-4183
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | DR.0059462
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 01072163A
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License Number State | IN
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