Provider Demographics
NPI:1043324502
Name:LEWIS LOSKOVITZ MD APC
Entity Type:Organization
Organization Name:LEWIS LOSKOVITZ MD APC
Other - Org Name:GERMANTOWN BACK PAIN RELIEF CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:I
Authorized Official - Last Name:LOSKOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-754-8880
Mailing Address - Street 1:2018 GERMANTOWN RD S
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138
Mailing Address - Country:US
Mailing Address - Phone:901-754-8880
Mailing Address - Fax:901-754-8883
Practice Address - Street 1:2018 GERMANTOWN RD S
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138
Practice Address - Country:US
Practice Address - Phone:901-754-8880
Practice Address - Fax:901-754-8883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD7536207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2000090OtherBCBS
2000090OtherBCBS
B02422Medicare UPIN