Provider Demographics
NPI:1801207360
Name:LEWIS, GEORGE WELDON (VMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WELDON
Last Name:LEWIS
Suffix:
Gender:M
Credentials:VMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4842 ABSOLUTE DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:FL
Mailing Address - Zip Code:32046-6314
Mailing Address - Country:US
Mailing Address - Phone:904-845-1985
Mailing Address - Fax:904-845-3099
Practice Address - Street 1:4842 ABSOLUTE DR
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:FL
Practice Address - Zip Code:32046-6314
Practice Address - Country:US
Practice Address - Phone:904-845-1985
Practice Address - Fax:904-845-3099
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-17
Last Update Date:2014-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLVM6786174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian