Henry J. Lewis, Md Pc | |
5606 Captains Ct Gainesville GA 30504-8197 | |
(770) 532-0666 | |
(770) 532-0666 |
Full Name | Henry J. Lewis, Md Pc |
---|---|
Speciality | Clinic/Center |
Location | 5606 Captains Ct, Gainesville, Georgia |
Authorized Official Name and Position | Henry J Lewis (PRESIDENT) |
Authorized Official Contact | 7705320666 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Henry J. Lewis, Md Pc 5606 Captains Ct Gainesville GA 30504-8197 Ph: (770) 532-0666 | Henry J. Lewis, Md Pc 5606 Captains Ct Gainesville GA 30504-8197 Ph: (770) 532-0666 |
NPI Number | 1326237355 |
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Provider Enumeration Date | 10/16/2007 |
Last Update Date | 10/29/2018 |
Medicare PECOS PAC ID | 8729050927 |
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Medicare Enrollment ID | O20040809000906 |
Identifier | Type | State | Issuer |
---|---|---|---|
1326237355 | NPI | - | NPPES |
08BBRBW | Other | GA | MEDICARE P-TAN |
DC0733 | Other | GA | RAILROAD MCARE PIN |
000875531B | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 049052 (Georgia) | Primary |
Provider Name | Henry J Lewis |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1326057621 PECOS PAC ID: 3476525684 Enrollment ID: I20040809000967 |
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