Provider Demographics
NPI:1396814315
Name:LESKO, JOHN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:LESKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:103 CLIFTON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1460
Mailing Address - Country:US
Mailing Address - Phone:434-528-4640
Mailing Address - Fax:434-528-4643
Practice Address - Street 1:103 CLIFTON ST
Practice Address - Street 2:PCA PAIN CARE - SUITE B
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1460
Practice Address - Country:US
Practice Address - Phone:434-528-4640
Practice Address - Fax:434-528-4643
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101240381207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA297015OtherANTHEM BLUE CROSS BLUE SHIELD
VA010406871Medicaid
VA297015OtherANTHEM BLUE CROSS BLUE SHIELD