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Contact Information

RANDAL J LEWIS, MD
3665 S 8400 W
SUITE 110
MAGNA, UT84044-4907
 Phone: 801-250-9638
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Legal Medicine

173000000X
Indicates primary specialty

NPI Profile & details for RANDAL J LEWIS · (Male)

NPI # 1215964309
Status Active
Credentials MD
Entity Individual
Enumeration date 06/26/2006
Last updated 08/02/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 89-246
  • UT License # 6901924-1205
  • NM Medicaid E2139
  • NM Other 4468903 AETNA PROVIDER NUMBER
  • NM Other 002400968 CIGNA PROVIDER NUMBER
Hospital affiliation(s) Not Available
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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