Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 2004007498 | MO |
NPI | 1801935671 |
---|---|
Provider Name | Dr. Thomas R Lewis |
First Address | Oklahoma City, OK 73117-1039 |
Second Address | Oklahoma City, OK 73104-4600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 01/04/2011 |