Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 48844 | KY |
Y | 208600000X | Surgeon | 48844 | KY |
NPI | 1003096116 |
---|---|
Provider Name | David S Lewis |
First Address | Ashland, KY 41105-2379 |
Second Address | Ashland, KY 41101-2877 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2007 |
Last Update Date | 02/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0160087 | (05) | OH |