Lewis, Cody W

Lewis, Cody W is an individual health care provider with primary practice located at 2300 E 30Th St Bldg D Ste 101 , Farmington NM 87401. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Lewis, Cody W can be contacted via phone (505) 327-1400.

Contact Information

Primary practice address
2300 E 30Th St Bldg D Ste 101 Farmington NM 87401
Fax: (505) 564-3202
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA60796883 Washington
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA2012-0021 New Mexico

Profile Details

NPI number 1972859403
LBN Legal business name Lewis, Cody W
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2012
Last updated Jan 18th, 2021 - about 5 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 1972859403 NPPES
New Mexico MEDICAID 58372539

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