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NPI Code Detail

MEDICARE: ZACHARY R LEWTON MD

MEDICARE:   ZACHARY R LEWTON  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology Physician35-084645OH
22084N0400XNeurology PhysicianC55988CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00180585OTHEROHRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2108873OTHEROHKAISER
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4000000341686OTHEROHANTHEM BLUECROSS/BLUESHEI
5341097565ZLOTHEROHSUMMACARE
6729710OTHEROHBUCKEYE COMMUNITY HEALTH

General Provider Information

NPI Number : 1346202975
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY R LEWTON MD
Provider Business Mailing Address
First Line : 1194 MONTGOMERY DR
Second Line :
City : SANTA ROSA
State : CA
Zip : 95405-4802
Country : US
Telephone Number : 707-303-1714
Fax Number :
Provider Business Practice Location Address
First Line : 1194 MONTGOMERY DR
Second Line :
City : SANTA ROSA
State : CA
Zip : 95405-4802
Country : US
Telephone Number : 707-303-1714
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2006
Last Update Date : 11/05/2021

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Directions to “ ZACHARY R LEWTON MD” Practice Location

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