NPI 1104193606

Kevin J Lewis, RT

Practitioner Radiologic Technologist Ellenwood, GA

Practice location

Address: 5434 Emily Cir, Ellenwood, GA 30294-4326
Phone: (404) 784-8792
Fax: (678) 422-3857
Mailing address: PO Box 887, Rex, GA 30273-0887

Registered specialties (2)

Radiologic Technologist Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247100000X

Other Radiologic Technologist providers in Georgia →

Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

Suppliers Taxonomy 335V00000X

Other Portable X-ray and/or Other Portable Diagnostic Imaging Supplier providers in Georgia →

Registry record

NPI: 1104193606
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Nov 2011
Record last updated: 28 Nov 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.