| Dr Gina R Lewis, MD | |
|
1300 E Center St, Utah State Hospital, Provo, UT 84606-3554 | |
| (801) 344-4400 | |
| (801) 344-4225 |
| Full Name | Dr Gina R Lewis |
|---|---|
| Gender | Female |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1300 E Center St, Provo, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144266321 | NPI | - | NPPES |
| D5600 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 3639681205 (Utah) | Primary |
| Entity Name | State Of Utah |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811978620 PECOS PAC ID: 6800797333 Enrollment ID: O20040117000195 |
| Entity Name | Physician Group Of Utah Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477676930 PECOS PAC ID: 8022032234 Enrollment ID: O20060113000886 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gina R Lewis, MD Po Box 270, Provo, UT 84603-0270 Ph: (801) 344-4400 | Dr Gina R Lewis, MD 1300 E Center St, Utah State Hospital, Provo, UT 84606-3554 Ph: (801) 344-4400 |
Edward Leslie Kelly, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1300 E Center St, Provo, UT 84606 Phone: 801-344-4400 Fax: 801-344-4225 | |
Brent L Griffin, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-4542 | |
Aaron William Sanders, DO Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 395 W Cougar Blvd Ste 601, Provo, UT 84604 Phone: 801-357-7525 | |
Sam J Coates, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-4542 | |
Dr. Rodney A Cheal, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1300 E Center St, Provo, UT 84606 Phone: 801-344-4400 | |
Ms. Madhumathy Gundlapalli, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1300 E Center St, Provo, UT 84606 Phone: 801-344-4400 | |
Marianela Rosales Gerpe, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1300 E Center St, Provo, UT 84606 Phone: 801-344-4400 Fax: 801-344-4215 |