Provider Demographics
NPI:1952989675
Name:LEWIS, HALLYE M (MD)
Entity type:Individual
Prefix:
First Name:HALLYE
Middle Name:M
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1867 CRANE RIDGE DR STE 101B
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4956
Mailing Address - Country:US
Mailing Address - Phone:601-362-8776
Mailing Address - Fax:601-709-8501
Practice Address - Street 1:539C HWY 80 WEST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-4500
Practice Address - Country:US
Practice Address - Phone:601-362-8776
Practice Address - Fax:601-924-0988
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2024-06-21
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Provider Licenses
StateLicense IDTaxonomies
MS33425208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics