Provider Demographics
NPI:1710327366
Name:LOHR, BENJAMIN NORRIS (PA-C)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:NORRIS
Last Name:LOHR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1524 EUBANK BLVD NE STE 6
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-4160
Mailing Address - Country:US
Mailing Address - Phone:505-503-8806
Mailing Address - Fax:888-503-8511
Practice Address - Street 1:1524 EUBANK BLVD NE STE 6
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-4160
Practice Address - Country:US
Practice Address - Phone:505-503-8806
Practice Address - Fax:888-503-8511
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPA2013-0025208100000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation