Provider Demographics
NPI:1811014608
Name:JOSEPH LEWIS DPM PC
Entity Type:Organization
Organization Name:JOSEPH LEWIS DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:740-264-7064
Mailing Address - Street 1:4100 JOHNSON RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2356
Mailing Address - Country:US
Mailing Address - Phone:740-264-7064
Mailing Address - Fax:740-266-7728
Practice Address - Street 1:4100 JOHNSON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2356
Practice Address - Country:US
Practice Address - Phone:740-264-7064
Practice Address - Fax:740-266-7728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-25
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-2864213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6218880001Medicare NSC