Provider Demographics
NPI:1780806653
Name:LEWIS, ROBERT BOYD IV (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BOYD
Last Name:LEWIS
Suffix:IV
Gender:M
Credentials:OD
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Mailing Address - Street 1:9488 WINFIELD PLACE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-5126
Mailing Address - Country:US
Mailing Address - Phone:334-727-0550
Mailing Address - Fax:334-724-6812
Practice Address - Street 1:2400 HOSPITAL ROAD (115-S)
Practice Address - Street 2:CAVHCS EYE CLINIC
Practice Address - City:TUSKEGEE
Practice Address - State:AL
Practice Address - Zip Code:36083-5001
Practice Address - Country:US
Practice Address - Phone:334-727-0550
Practice Address - Fax:334-724-6812
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-18
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Provider Licenses
StateLicense IDTaxonomies
CA8776 TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist