| Jack K Lewis Md Pc | |
|
220 N 89th St Suite 101 Omaha NE 68114-4072 | |
| (402) 393-3616 | |
| (402) 393-4347 |
| Full Name | Jack K Lewis Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 220 N 89th St, Omaha, Nebraska |
| Authorized Official Name and Position | Jack K Lewis (PRESIDENT) |
| Authorized Official Contact | 4023933616 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack K Lewis Md Pc 220 N 89th St Suite 101 Omaha NE 68114-4072 Ph: (402) 393-3616 | Jack K Lewis Md Pc 220 N 89th St Suite 101 Omaha NE 68114-4072 Ph: (402) 393-3616 |
| NPI Number | 1760563373 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 09/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760563373 | NPI | - | NPPES |
| 10026059900 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 10515 (Nebraska) | Primary |
| 363A00000X | Physician Assistant | 778 (Nebraska) | Secondary |
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