Tara Miranda Lewis, P.A.-C

NPI #1962682104 in Ardmore, Oklahoma

Provider Information

NPI Number: 1962682104
Entity Type: Individual
Name: Tara Miranda Lewis, P.A.-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: P.A.-C
Enumeration Date: Nov 5, 2007
Last Updated: Jul 10, 2024

Practice Location

Address: 2510 CHICKASAW BLVD
City: Ardmore
State: Oklahoma
ZIP Code: 73401-1341
Phone: (580) 226-8181

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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