Provider Demographics
NPI:1831127703
Name:LEWIS-PADGETT, KATHRYN E (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:E
Last Name:LEWIS-PADGETT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5163 W CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-4937
Mailing Address - Country:US
Mailing Address - Phone:678-883-8443
Mailing Address - Fax:678-838-4093
Practice Address - Street 1:4935 STEWART MILL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-6733
Practice Address - Country:US
Practice Address - Phone:678-838-4433
Practice Address - Fax:678-838-4093
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO006715111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00106701Medicare UPIN
GA35ZCHMVMedicare ID - Type Unspecified