Provider Demographics
NPI:1811903255
Name:LEWIS, FLORENCE C (MD)
Entity type:Individual
Prefix:DR
First Name:FLORENCE
Middle Name:C
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE
Mailing Address - Street 2:STE 1200
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3361
Mailing Address - Country:US
Mailing Address - Phone:918-488-6687
Mailing Address - Fax:918-488-6098
Practice Address - Street 1:6151 S YALE AVE STE 1305
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1907
Practice Address - Country:US
Practice Address - Phone:918-494-9450
Practice Address - Fax:918-494-9437
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ56042086S0120X, 2086S0120X
SD89502086S0120X, 2086S0120X
IA411032086S0120X
FLME892242086S0120X
OK299232086S0120X
KS04-365962086S0120X
LA09849R2086S0120X
NY2736912086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05435273Medicaid
TNQ009186Medicaid
AL009951795Medicaid
AR214450001Medicaid
FL270271100Medicaid
SD103I025576Medicare PIN
G38331Medicare UPIN
37576ZMedicare PIN