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General NPI Number Information
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NPI Number | 1861762676
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Entity Type | Organization
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Legal Business Name | DR LISA LEWIS PC
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 01/10/2012
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Provider Practice Location Address
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Address Line | 12600 W COLFAX AVE STE A110
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City | LAKEWOOD
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State | CO
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Zip | 80215-3785
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Country | US
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Telephone | 303-386-4434
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Fax |
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Provider Business Mailing Address
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Address Line | 12600 W COLFAX AVE STE A110
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City | LAKEWOOD
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State | CO
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Zip | 80215-3785
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Country | US
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Telephone | 303-386-4434
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER & SECRETARY
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Name | DR. LISA K. LEWIS
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Credential | D.O.
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Telephone | 303-386-4434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 28939
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License Number State | CO
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