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General NPI Number Information
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NPI Number | 1700150513
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Entity Type | Organization
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Legal Business Name | JACQUELINE B. LEWIS, MD, PC
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Dates
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Enumeration Date | 02/27/2012
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Last Update Date | 03/12/2012
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Provider Practice Location Address
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Address Line | 801 PRINCETON AVE SW SUITE 108
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City | BIRMINGHAM
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State | AL
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Zip | 35211-1310
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Country | US
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Telephone | 205-780-6090
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Fax | 205-780-3060
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Provider Business Mailing Address
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Address Line | 801 PRINCETON AVE SW SUITE 108
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City | BIRMINGHAM
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State | AL
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Zip | 35211-1310
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Country | US
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Telephone | 205-780-6090
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Fax | 205-780-3060
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JACQUELINE BELINDA LEWIS
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Credential | M.D.
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Telephone | 205-780-6090
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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 | 11827
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License Number State | AL
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