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Contact Information

CODY W LEWIS, PA-C
2300 E 30TH ST BLDG D STE 101
FARMINGTON, NM87401
 Phone: 505-327-1400
 Fax: 505-564-3202
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for CODY W LEWIS · (Male)

NPI # 1972859403
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 08/02/2012
Last updated 01/18/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • NM License # PA2012-0021
  • WA License # PA60796883
  • NM Medicaid 58372539
Hospital affiliation(s)
  • REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES - (Acute Care)
    1901 RED ROCK DRIVE
    GALLUP, NM 87301
  • SAN JUAN REGIONAL MEDICAL CENTER - (Acute Care)
    801 WEST MAPLE STREET
    FARMINGTON, NM 87401
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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