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Contact Information

CREIGHTON LEWIS, MD
500 WEST FORT ST. #111R
BOISE VAMC
BOISE, ID83702
 Phone: 208-220-6546
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for CREIGHTON LEWIS · (Male)

NPI # 1376920553
Status Active
Credentials MD
Entity Individual
Enumeration date 04/27/2015
Last updated 06/09/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • UT License # 11682730-1205
Hospital affiliation(s)
  • ST LUKE'S JEROME - (Critical Access)
    709 NORTH LINCOLN AVENUE
    JEROME, ID 83338
  • ST LUKE'S MCCALL - (Critical Access)
    1000 STATE STREET
    MC CALL, ID 83638
  • ST LUKES MAGIC VALLEY RMC - (Acute Care)
    801 POLE LINE ROAD WEST
    TWIN FALLS, ID 83301
  • ST LUKES REGIONAL MEDICAL CENTER - (Acute Care)
    190 EAST BANNOCK STREET
    BOISE, ID 83712
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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