Provider Demographics
NPI:1851520472
Name:LEWIS, JAMES (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:LEWIS
Suffix:
Gender:M
Credentials:DO
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 275
Mailing Address - Street 2:
Mailing Address - City:UWCHLAND
Mailing Address - State:PA
Mailing Address - Zip Code:19480-0275
Mailing Address - Country:US
Mailing Address - Phone:215-738-2954
Mailing Address - Fax:484-341-8184
Practice Address - Street 1:102 PICKERING WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1330
Practice Address - Country:US
Practice Address - Phone:215-738-2954
Practice Address - Fax:484-341-8184
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005194L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice