Walter J Lewis
Dermatologist
14537 W Indian School Rd #700
Goodyear
, Arizona 85395-9243
Walter J Lewis
Dermatologist
14537 W Indian School Rd #700
Goodyear
, Arizona 85395-9243
(623) 974-9351
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Walter J Lewis
- 13943 N 91 Avenue C-101
- Peoria, AZ
- Zip : 85381-3629
- Fax : (623) 974-9351
- Phone : (623) 760-9449
Second Address
- Walter J Lewis
- 14537 W Indian School Rd #700
- Goodyear, AZ
- Zip : 85395-9243
- Fax : (623) 974-9351
- Phone : (623) 935-0247
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | 40648 | AZ |
National Provider Identifier
| NPI | 1013044999 |
|---|---|
| Provider Name | Walter J Lewis |
| First Address | Peoria, AZ 85381-3629 |
| Second Address | Goodyear, AZ 85395-9243 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/02/2007 |
| Last Update Date | 04/10/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1013044999 | BLUE CROSS BLUE SHIELD (01) | AZ |
| 1013044999 | TRICARE (01) | AZ |
| 1081859 | UNITED HEALTHCARE (01) | AZ |
| 40648 | STATE LICENSE (01) | AZ |
| 4Z2980 | HEALTH NET (01) | AZ |
| 608299 | (05) | AZ |
| 608299 | AETNA (01) | AZ |
| 608299 | AHCCCS (01) | AZ |
| A47020 | (02) | AZ |
| P00725809 | RAILROAD MEDICARE (01) | AZ |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.