Provider Demographics
NPI:1912441965
Name:SCOTT F LEWIS DO PLLC
Entity Type:Organization
Organization Name:SCOTT F LEWIS DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:606-802-3400
Mailing Address - Street 1:26 OXFORD WAY
Mailing Address - Street 2:SUITE D
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2813
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26 OXFORD WAY
Practice Address - Street 2:SUITE D
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2813
Practice Address - Country:US
Practice Address - Phone:606-802-2300
Practice Address - Fax:606-802-2400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-10
Last Update Date:2016-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03390207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty