Lewis, Alan

Lewis, Alan is an sole proprietor health care provider with primary practice located at 1245 42Nd Ave , Gulfport MS 39501-2666. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Lewis, Alan can be contacted via phone (228) 864-8049.

Contact Information

Primary practice address
1245 42Nd Ave Gulfport MS 39501-2666
Fax: (228) 864-7655
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 14710R Louisiana
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 17858 Mississippi

Profile Details

NPI number 1912090143
LBN Legal business name Lewis, Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 2nd, 2006
Last updated Feb 5th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912090143 NPPES
Louisiana MEDICAID 1136697

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