Provider Demographics
NPI:1043214737
Name:LEWIS, JOYCE ROCHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:ROCHELLE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3700 MARKET ST
Mailing Address - Street 2:STE C
Mailing Address - City:CLARKSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30021-2652
Mailing Address - Country:US
Mailing Address - Phone:404-298-9333
Mailing Address - Fax:404-298-9931
Practice Address - Street 1:3700 MARKET ST
Practice Address - Street 2:STE C
Practice Address - City:CLARKSTON
Practice Address - State:GA
Practice Address - Zip Code:30021-2652
Practice Address - Country:US
Practice Address - Phone:404-298-9333
Practice Address - Fax:404-298-9931
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA041874207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000708408RMedicaid
AETNAOther5790459
0101285OtherUNITED HEALTHCARE
1036625-300OtherFIRST HEALTH
GA000708408SMedicaid
0864145006OtherCIGNA
GA1215932751OtherGROUP NP
21149336803OtherBEECHSTREET
52508065-003OtherBLUE CROSS BLUE SHIELD
588779OtherAETNA
52508065-003OtherBLUE CROSS BLUE SHIELD
GA1215932751OtherGROUP NP