Healthcare Provider Details

I. General information

NPI: 1578567905
Provider Name (Legal Business Name): ROBERT C LEHMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2005
Last Update Date: 05/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 E 30TH ST BLDG D STE 101
FARMINGTON NM
87401-8990
US

IV. Provider business mailing address

2300 E 30TH ST BLDG D STE 101
FARMINGTON NM
87401-8990
US

V. Phone/Fax

Practice location:
  • Phone: 505-327-1400
  • Fax: 505-347-3474
Mailing address:
  • Phone: 505-327-1400
  • Fax: 505-347-3474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number72178
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: