Provider Demographics
NPI:1730178559
Name:LEHMAN, JOHN MARK (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MARK
Last Name:LEHMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 COMPASSION WAY
Mailing Address - Street 2:
Mailing Address - City:DODGEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53533-1956
Mailing Address - Country:US
Mailing Address - Phone:608-930-8000
Mailing Address - Fax:608-930-7251
Practice Address - Street 1:800 COMPASSION WAY
Practice Address - Street 2:
Practice Address - City:DODGEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53533-1956
Practice Address - Country:US
Practice Address - Phone:608-930-8000
Practice Address - Fax:608-930-7251
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI21758207Q00000X
WI7503207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI21758021OtherSTATE OF WISCONSIN LICENSING
WI3989-0800Medicaid
WI21758021OtherLICENSE
WI21758021OtherSTATE OF WISCONSIN LICENSING
WIWI1085Medicare Oscar/Certification