Provider Demographics
NPI:1376570390
Name:LEWIS, LLOYD (MD)
Entity Type:Individual
Prefix:
First Name:LLOYD
Middle Name:
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W RAMPART ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-8846
Mailing Address - Country:US
Mailing Address - Phone:317-398-0193
Mailing Address - Fax:317-398-1851
Practice Address - Street 1:2451 INTELLIPLEX DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-8535
Practice Address - Country:US
Practice Address - Phone:317-398-0193
Practice Address - Fax:317-398-0727
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01046108A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INCJ8747OtherRAILROAD MEDICARE
INCJ8747OtherRAILROAD MEDICARE
INCJ8747OtherRAILROAD MEDICARE
D50887Medicare UPIN