NPI 1235771239

Adam Lewis

Practitioner Military Health Care Provider Hattiesburg, MS

Practice location

Address: 6051 U S Highway 49, Hattiesburg, MS 39401-7200
Phone: (601) 288-2690
Mailing address: 22 Ashborough Ln, Hattiesburg, MS 39402-6100

Registered specialties (2)

Military Health Care Provider Primary

Other Service Providers Taxonomy 171000000X

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Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA00597 (MS)

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Registry record

NPI: 1235771239
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Oct 2019
Record last updated: 5 Oct 2021

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.