Provider Demographics
NPI:1801006127
Name:LEWIS, ROZMOND JOHNSON (MD)
Entity type:Individual
Prefix:DR
First Name:ROZMOND
Middle Name:JOHNSON
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-239-2018
Mailing Address - Fax:
Practice Address - Street 1:3443 DICKERSON PIKE STE 290
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2534
Practice Address - Country:US
Practice Address - Phone:615-469-5555
Practice Address - Fax:615-469-5432
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50708207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34932200Medicaid
WI0097:01545Medicare PIN