Organization
PETER LUSICH ANESTHESIA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER LUSICH (OWNER)
(775) 315-1384
Entity
Organization
Contact information
Practice address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 882-6311
Mailing address
PO BOX 1359, KLAMATH FALLS, OR 97601-0075
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
11770
NV
Other
Enumeration date
10/17/2012
Last updated
10/17/2012
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