Lewis, Randal John

Lewis, Randal John is an individual health care provider with primary practice located at 310 E 4500 S Ste 410 , Murray UT 84107-3993. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Legal Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Lewis, Randal John can be contacted via phone (801) 850-2800.

Contact Information

Primary practice address
310 E 4500 S Ste 410 Murray UT 84107-3993
Phone: (801) 850-2800
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X 89-246 New Mexico
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 6901924-1205 Utah

Profile Details

NPI number 1215964309
LBN Legal business name Lewis, Randal John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Aug 2nd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215964309 NPPES
New Mexico MEDICAID E2139
New Mexico Other 002400968
New Mexico Other 4468903

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