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Individual

DR. DAVID P. LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D. PC

Contact information

Practice address
990 SOUTH MEDICAL DR, SUITE G3, BRIGHAM CITY, UT 84302-3077
(435) 734-2097
(435) 734-0532
Mailing address
990 SOUTH MEDICAL DR, SUITE G3, BRIGHAM CITY, UT 84302-3077
(435) 734-2097
(435) 734-0532

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
171336-1205
UT
174400000X
Specialist
Primary
1713361205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003026200
ID
Enumeration date
07/14/2005
Last updated
03/01/2012
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