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NPI Code Detail

MEDICARE: DR. JOHN E LOMAX M.D.

MEDICARE:  DR. JOHN E LOMAX  M.D.
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
1208200000XPlastic Surgery PhysicianIL

General Provider Information

NPI Number : 1417923517
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN E LOMAX M.D.
Provider Business Mailing Address
First Line : 4909 N GLEN PARK PLACE RD
Second Line :
City : PEORIA
State : IL
Zip : 61614-4676
Country : US
Telephone Number : 309-674-7546
Fax Number :
Provider Business Practice Location Address
First Line : 4909 N GLEN PARK PLACE RD
Second Line :
City : PEORIA
State : IL
Zip : 61614-4676
Country : US
Telephone Number : 309-674-7546
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 07/08/2007

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Directions to “ DR. JOHN E LOMAX M.D.” Practice Location

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