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Individual

DONALD RYAN LEWIS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3448 US ROUTE 60, HUNTINGTON, WV 25705-2906
(304) 522-1550
(304) 522-0704
Mailing address
PO BOX 910, HUNTINGTON, WV 25712-0910
(304) 522-1550
(304) 522-1073

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18979
WV
2085R0202X
Diagnostic Radiology Physician
33032
KY
2085R0202X
Diagnostic Radiology Physician
35.080554
OH
2085R0202X
Diagnostic Radiology Physician
DO041346
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000196333
UNISON
OH
01
001718777
MTN STATE BCBS
05
012206000
WV
05
2018739
OH
01
300081882
RR MEDICARE (WV)
WV
01
50007262
PASSPORT
KY
01
5389160
AETNA
01
550493376
WORKMANS COMP
WV
05
6494193300
KY
01
P00766025
RR MEDICARE (KY)
KY
Enumeration date
12/22/2005
Last updated
04/18/2024
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