Provider Demographics
NPI:1437235835
Name:LEHRER, JOHN BAPTISTE (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:BAPTISTE
Last Name:LEHRER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2099 CRITESER LOOP
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OR
Mailing Address - Zip Code:97391
Mailing Address - Country:US
Mailing Address - Phone:541-336-1628
Mailing Address - Fax:
Practice Address - Street 1:775 SW 9TH ST
Practice Address - Street 2:SUITE G
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-4895
Practice Address - Country:US
Practice Address - Phone:541-265-3772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD20706207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR150442Medicaid
OR150442Medicaid