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NPI Code Detail

MEDICARE: DR. GEORGE LUKE LEWIS MD

MEDICARE: DR. GEORGE LUKE LEWIS MD
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
1207N00000XDermatology PhysicianE-0459AR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2070007653OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417978958
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE LUKE LEWIS MD
Provider Business Mailing Address
First Line : 7900 DALLAS STREET
Second Line :
City : FORT SMITH
State : AR
Zip : 72903
Country : US
Telephone Number : 479-242-6647
Fax Number : 479-250-0505
Provider Business Practice Location Address
First Line : 7900 DALLAS STREET
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-5690
Country : US
Telephone Number : 479-242-6647
Fax Number : 479-250-0505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 02/04/2021

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Directions to “ DR. GEORGE LUKE LEWIS MD” Practice Location

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