MEDICARE: DR. ALAN LAIRD LEWIS O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	4901003611	MI

General Provider Information

NPI Number	:	1033281894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN LAIRD LEWIS O.D.

Provider Business Mailing Address
First Line	:	282 E RIDING DR
Second Line	:
City	:	CARLISLE
State	:	MA
Zip	:	01741-1601
Country	:	US
Telephone Number	:	978-287-0049
Fax Number	:	978-287-0049

Provider Business Practice Location Address
First Line	:	282 E RIDING DR
Second Line	:
City	:	CARLISLE
State	:	MA
Zip	:	01741-1601
Country	:	US
Telephone Number	:	978-287-0049
Fax Number	:	978-287-0049

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	07/08/2007

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