Provider Demographics
NPI:1427017870
Name:LEWTON, H DENNIS II (OD)
Entity Type:Individual
Prefix:DR
First Name:H
Middle Name:DENNIS
Last Name:LEWTON
Suffix:II
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6905 EAST 96TH STREET
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250
Mailing Address - Country:US
Mailing Address - Phone:317-576-9809
Mailing Address - Fax:317-585-9823
Practice Address - Street 1:6905 EAST 96TH STREET
Practice Address - Street 2:SUITE 1100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250
Practice Address - Country:US
Practice Address - Phone:317-576-9809
Practice Address - Fax:317-585-9823
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002780A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200062270Medicaid
IN160450IMedicare PIN
IN410035890Medicare PIN
IN200062270Medicaid