1699811240 NPI number — DR. WAYNE MURRAY LEWIS DC DOCTOR OF CHIROPR

Table of content: DR. WAYNE MURRAY LEWIS DC DOCTOR OF CHIROPR (NPI 1699811240)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699811240 NPI number — DR. WAYNE MURRAY LEWIS DC DOCTOR OF CHIROPR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEWIS
Provider First Name:
WAYNE
Provider Middle Name:
MURRAY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC DOCTOR OF CHIROPR
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699811240
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1164 WEST COUNTY ROAD 125 SOUTH
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENCASTLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46135-8478
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
765-653-3454
Provider Business Mailing Address Fax Number:
765-653-0871

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1164 WEST COUNTY ROAD 125 SOUTH
Provider Second Line Business Practice Location Address:
WEST WALNUT STREET ROAD
Provider Business Practice Location Address City Name:
GREENCASTLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46135-8478
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-653-3454
Provider Business Practice Location Address Fax Number:
765-653-0871
Provider Enumeration Date:
01/30/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  08000474A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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