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General NPI Number Information
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NPI Number | 1801935671
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Entity Type | Individual
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Provider Name | THOMAS R LEWIS MD
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Gender | Male
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 04/01/2011
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Provider Practice Location Address
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Address Line | 1200 N PHILLIPS AVE OUCP3100
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-4600
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Country | US
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Telephone | 405-271-2669
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Fax | 405-271-5313
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Provider Business Mailing Address
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Address Line | 1122 NE 13TH ST ORI 236
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City | OKLAHOMA CITY
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State | OK
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Zip | 73117-1039
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Country | US
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Telephone | 405-271-8096
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Fax | 405-271-5313
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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 | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 2004007498
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License Number State | MO
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