Healthcare Provider Details

I. General information

NPI: 1720077175
Provider Name (Legal Business Name): JAMES D. LOHMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 01/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 5TH AVE W SUITE 2
JEROME ID
83338-1825
US

IV. Provider business mailing address

PO BOX 587
TWIN FALLS ID
83303-0587
US

V. Phone/Fax

Practice location:
  • Phone: 208-814-9800
  • Fax: 208-814-9833
Mailing address:
  • Phone: 208-814-7400
  • Fax: 208-814-7491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberM-4212
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: