Individual
DR. RANDAL JOHN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
310 E 4500 S STE 410, MURRAY, UT 84107-3993
(801) 850-2800
Mailing address
1082 N 1000 W, AMERICAN FORK, UT 84003-3897
(801) 850-2800
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
89-246
NM
207Q00000X
Family Medicine Physician
Primary
6901924-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002400968
CIGNA PROVIDER NUMBER
NM
01
—
4468903
AETNA PROVIDER NUMBER
NM
05
—
E2139
—
NM
Enumeration date
06/26/2006
Last updated
08/02/2020
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