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Individual

DR. RONALD JAMES LEWELLYN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
827 SOUTHWESTERN RUN, POLAND, OH 44514-3688
(330) 758-3819
(330) 758-4965
Mailing address
827 SOUTHWESTERN RUN, POLAND, OH 44514-3688
(330) 758-3819
(330) 758-4965

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4295
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000248739
ANTHEM IND #
OH
01
11389741
CAQH PROVIDER ID#
OH
01
162919
GM/PACKARD/CIGNA
OH
01
227276000
MAGELLAN MIS #
OH
01
334924
MHS #
OH
01
4295
OHIO LICENSE #
OH
Enumeration date
05/19/2006
Last updated
10/06/2011
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