Provider Demographics
NPI:1922150531
Name:LEWIS, JAWAUN M (DO)
Entity Type:Individual
Prefix:DR
First Name:JAWAUN
Middle Name:M
Last Name:LEWIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1704 CHELSEA DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-4317
Mailing Address - Country:US
Mailing Address - Phone:405-206-5492
Mailing Address - Fax:402-479-5408
Practice Address - Street 1:3280 MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-8022
Practice Address - Country:US
Practice Address - Phone:405-579-5858
Practice Address - Fax:405-292-1787
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE5172084P0800X
OK40922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry