| Angela D Lewis Do Psc | |
|
1021 Kenwood Dr Russell KY 41169-1527 | |
| (606) 836-1954 | |
| (606) 836-3878 |
| Full Name | Angela D Lewis Do Psc |
|---|---|
| Speciality | Family Medicine |
| Location | 1021 Kenwood Dr, Russell, Kentucky |
| Authorized Official Name and Position | Angela D Lewis (OWNER) |
| Authorized Official Contact | 6068361954 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angela D Lewis Do Psc 1021 Kenwood Dr Russell KY 41169-1527 Ph: (606) 836-1954 | Angela D Lewis Do Psc 1021 Kenwood Dr Russell KY 41169-1527 Ph: (606) 836-1954 |
| NPI Number | 1821398173 |
|---|---|
| Provider Enumeration Date | 11/02/2010 |
| Last Update Date | 11/02/2010 |
| Medicare PECOS PAC ID | 4688690308 |
|---|---|
| Medicare Enrollment ID | O20051021000021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821398173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 02545 (Kentucky) | Primary |
| Provider Name | Angela Dawn Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710073580 PECOS PAC ID: 7810181757 Enrollment ID: I20101104000377 |
Supportive Med Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1619 Diederich Blvd Ste B, Russell, KY 41169 Phone: 606-324-0334 |