Basic Information
| Provider Information | |||||||||
| NPI: | 1922329382 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEWTON | ||||||||
| FirstName: | AMANDA | ||||||||
| MiddleName: | KAY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2550 LUSK DR | ||||||||
| Address2: | |||||||||
| City: | NEOSHO | ||||||||
| State: | MO | ||||||||
| PostalCode: | 648508855 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4174512060 | ||||||||
| FaxNumber: | 4174516214 | ||||||||
| Practice Location | |||||||||
| Address1: | 2550 LUSK DR | ||||||||
| Address2: | |||||||||
| City: | NEOSHO | ||||||||
| State: | MO | ||||||||
| PostalCode: | 648508855 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4174512060 | ||||||||
| FaxNumber: | 4174516214 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2010 | ||||||||
| LastUpdateDate: | 07/11/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2010017252 | MO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.