Tara Miranda Lewis P.A.-C

NPI 1962682104 - Physician Assistant - 363A00000X

NPI Details
NPI 1962682104
Gender Female
Enumeration Date 11/05/2007
Last Updated 07/11/2014
Entity Type Individual
Active Over 9 years ago
Practice Location
3472 HOSPITAL RD
HEALDTON OK, 73438-6124, US
Phone (580) 229-0079
Fax
Business Location
3472 HOSPITAL RD
HEALDTON OK, 73438-6124, US
Phone (580) 229-0079
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Oklahoma
License Number 1659
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According to our database, Tara Miranda Lewis P.A.-C NPI is 1962682104, taxonomy code is 363A00000X and license number is 1659, license state is located at Oklahoma. Tara Miranda Lewis P.A.-C physically located at 3472 Hospital Rd, Healdton OK, 73438-6124. NPI Number Tara Miranda Lewis P.A.-C has the Individual type.

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1962682104 NPI number is provided on an as is basis without warranty of any kind. 1962682104 is maintained by the National Plan & Provider Enumeration System. The contents of Tara Miranda Lewis P.A.-C are for informational purposes only.