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NPI Code Detail

MEDICARE: DEBRA DIANE LEWIS D.O.

MEDICARE: DEBRA DIANE LEWIS D.O.
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
1207Q00000XFamily Medicine Physician58004527OH
2207Q00000XFamily Medicine Physician34.011210OH
3207Q00000XFamily Medicine Physician3205TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447543970
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA DIANE LEWIS D.O.
Provider Business Mailing Address
First Line : 1275 DICK LONAS RD UNIT 101
Second Line :
City : KNOXVILLE
State : TN
Zip : 37909-1383
Country : US
Telephone Number : 865-584-4747
Fax Number : 606-408-6612
Provider Business Practice Location Address
First Line : 555 JUSTIS DR
Second Line :
City : GREENEVILLE
State : TN
Zip : 37745-4288
Country : US
Telephone Number : 423-783-7965
Fax Number : 833-908-2073
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2011
Last Update Date : 05/16/2025

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Directions to “ DEBRA DIANE LEWIS D.O.” Practice Location

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