Individual
DR. GINA R LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1300 E CENTER ST, UTAH STATE HOSPITAL, PROVO, UT 84606-3554
(801) 344-4400
(801) 344-4225
Mailing address
PO BOX 270, PROVO, UT 84603-0270
(801) 344-4400
(801) 344-4225
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
3639681205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D5600
—
UT
Enumeration date
06/22/2006
Last updated
02/28/2020
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