Provider Demographics
NPI:1497851372
Name:PAGEL, LEWIS JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:JAMES
Last Name:PAGEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 970
Mailing Address - Street 2:
Mailing Address - City:KOTZEBUE
Mailing Address - State:AK
Mailing Address - Zip Code:99752-0970
Mailing Address - Country:US
Mailing Address - Phone:907-412-1785
Mailing Address - Fax:907-442-4405
Practice Address - Street 1:151 SECOND AVE
Practice Address - Street 2:
Practice Address - City:KOTZEBUE
Practice Address - State:AK
Practice Address - Zip Code:99752-0970
Practice Address - Country:US
Practice Address - Phone:907-442-4435
Practice Address - Fax:907-442-4405
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4682111N00000X
AK455111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN88G23PAOtherBLUE CROSS BLUE SHIELD
MN620142300Medicaid
MN620142300Medicaid