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General NPI Number Information
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NPI Number | 1750477808
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Entity Type | Individual
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Provider Name | LEWIS HARGETT MD
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 10/07/2014
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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
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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 | PO BOX 39096
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City | LOUISVILLE
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State | KY
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Zip | 40233
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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 |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 26076
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License Number State | KY
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