Provider Demographics
NPI:1861762676
Name:DR LISA LEWIS PC
Entity type:Organization
Organization Name:DR LISA LEWIS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER & SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-386-4434
Mailing Address - Street 1:12600 W COLFAX AVE STE A110
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-3785
Mailing Address - Country:US
Mailing Address - Phone:303-386-4434
Mailing Address - Fax:
Practice Address - Street 1:12600 W COLFAX AVE STE A110
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-3785
Practice Address - Country:US
Practice Address - Phone:303-386-4434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO28939207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty