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Individual

JULIE NEWMANN LUCERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1307 W MAIN ST, MEDFORD, OR 97501-2936
(541) 535-6239
Mailing address
931 CHEVY WAY, MEDFORD, OR 97504-4127

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
PA00607
OR
363AM0700X
Medical Physician Assistant
Primary
PA00607
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5000637855
OR
Enumeration date
02/14/2007
Last updated
02/21/2025
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