Doctor Name: | PAUL YOSEPA LEWIS |
NPI Number: | 1770615312 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | C.PED, L.PED. |
License Number: | 56 |
Business Practice Address: | 1605a S Main St Broken Arrow, OK - 740125604 |
Business Phone Number: | 9182580206 |
Business Fax Number: | 9182580207 |
Mailing Address: | 1605a S Main St, BROKEN ARROW |
State: | OK |
Postal Code: | 740125604 |
Phone Number: | 9182580206 |
Fax Number: | 9182580207 |
NPI Enumeration Date: | 03/09/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 56 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |