# PETER LUSICH ANESTHESIA MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295088169
- **Authorized official:** DR. PETER LUSICH (OWNER)
- **Authorized official phone:** (775) 315-1384

## Contact information

- **Practice address:** 2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
- **Practice address phone:** (541) 882-6311
- **Mailing address:** PO BOX 1359, KLAMATH FALLS, OR 97601-0075

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 11770 | NV | Yes |

## Other

- **Enumeration date:** 10/17/2012
- **Last updated:** 10/17/2012