| Doctor Name: | ROD LEE LEWIS |
| NPI Number: | 1043523897 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NP |
| License Number: | RN068366 |
| Business Practice Address: | 1107 Memorial Dr Suite 200 Dalton, GA - 307208662 |
| Business Phone Number: | 7062269355 |
| Business Fax Number: | 7062269380 |
| Mailing Address: | Po Box 1587, DALTON |
| State: | GA |
| Postal Code: | 307221587 |
| Phone Number: | 7065297440 |
| Fax Number: | 7065297437 |
| NPI Enumeration Date: | 07/22/2010 |
| NPI Last Update Date: | 06/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN068366 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |