Provider Demographics
NPI:1376006965
Name:LEWIS, JADE JONEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JADE
Middle Name:JONEE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 557 BOX 415
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96379-0005
Mailing Address - Country:US
Mailing Address - Phone:316-622-9953
Mailing Address - Fax:
Practice Address - Street 1:U.S. NAVAL HOSPITAL OKINAWA
Practice Address - Street 2:
Practice Address - City:CHATAN
Practice Address - State:OKINAWA PREFECTURE
Practice Address - Zip Code:9040103
Practice Address - Country:JP
Practice Address - Phone:315-622-7632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME146984208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program