Provider Demographics
NPI:1801889191
Name:LEHR, JEFFREY MARK (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:MARK
Last Name:LEHR
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 1:3900 S ZINTEL WAY
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337
Mailing Address - Country:US
Mailing Address - Phone:509-942-3627
Mailing Address - Fax:
Practice Address - Street 1:1100 GOETHALS DRIVE, SUITE F
Practice Address - Street 2:KADLEC INLAND CARDIOLOGY
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352
Practice Address - Country:US
Practice Address - Phone:509-942-3272
Practice Address - Fax:509-942-3274
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71401207RC0000X
SC32078207RC0000X
WAMD60450187207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250706400Medicaid
SCGP4697OtherMEDICAID GROUP
SC8768OtherMEDICARE GROUP
SC320780Medicaid
SC320780Medicaid
SC8768OtherMEDICARE GROUP