Provider Demographics
NPI:1033281894
Name:LEWIS, ALAN LAIRD (OD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:LAIRD
Last Name:LEWIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:282 E RIDING DR
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:MA
Mailing Address - Zip Code:01741-1601
Mailing Address - Country:US
Mailing Address - Phone:978-287-0049
Mailing Address - Fax:978-287-0049
Practice Address - Street 1:282 E RIDING DR
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:MA
Practice Address - Zip Code:01741-1601
Practice Address - Country:US
Practice Address - Phone:978-287-0049
Practice Address - Fax:978-287-0049
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003611152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist