Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 052318 | GA |
N | 208800000X | Urologist | ME87147 | FL |
NPI | 1063480267 |
---|---|
Provider Name | James H Lewis |
First Address | Macon, GA 31217-8007 |
Second Address | Macon, GA 31217-8007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 06/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063480267 | NPI INDIVIDUAL (01) | GA |
1962538850 | NPI GROUP (01) | GA |
266608100 | (05) | FL |
H81054 | (02) | FL |