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NPI Code Detail

MEDICARE: DR. PHILIP ALDEN LEWIS JR. D.P.M.

MEDICARE: DR. PHILIP ALDEN LEWIS JR. D.P.M.
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
1213ES0131XFoot Surgery PodiatristPOD 209ME

General Provider Information

NPI Number : 1942206255
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHILIP ALDEN LEWIS JR. D.P.M.
Provider Business Mailing Address
First Line : 315 TWIN PONDS LN
Second Line :
City : VASS
State : NC
Zip : 28394-9266
Country : US
Telephone Number : 901-822-7131
Fax Number : 910-822-7035
Provider Business Practice Location Address
First Line : 2300 RAMSEY ST
Second Line : VA MEDICAL CENTER (112)
City : FAYETTEVILLE
State : NC
Zip : 28301-3856
Country : US
Telephone Number : 910-822-7131
Fax Number : 910-822-7035
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 11/18/2010

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