Individual
DR. JOHN RANDOLPH LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1236 E RUSHOLME ST, SUITE 300, DAVENPORT, IA 52803-2473
(563) 324-2992
(563) 888-0499
Mailing address
1236 E RUSHOLME ST, SUITE 300, DAVENPORT, IA 52803-2473
(563) 324-2992
(563) 888-0499
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
20857
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0156398
—
IA
Enumeration date
01/11/2006
Last updated
11/21/2007
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