Provider Demographics
NPI:1366442329
Name:LEWIS, ALAN G (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:G
Last Name:LEWIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6475 S YALE AVE
Mailing Address - Street 2:STE. 301
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-7816
Mailing Address - Country:US
Mailing Address - Phone:918-494-9300
Mailing Address - Fax:918-494-9324
Practice Address - Street 1:6475 S YALE AVE
Practice Address - Street 2:STE. 301
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7816
Practice Address - Country:US
Practice Address - Phone:918-494-9300
Practice Address - Fax:918-494-9324
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2022-05-17
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Provider Licenses
StateLicense IDTaxonomies
OK14551207XX0004X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKA37471Medicare UPIN