Provider Demographics
NPI:1386136281
Name:LOHKAMP, MARK ROBERT JR (DO)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ROBERT
Last Name:LOHKAMP
Suffix:JR
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 1:5515 PEACH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-2695
Mailing Address - Country:US
Mailing Address - Phone:814-868-8294
Mailing Address - Fax:814-868-2489
Practice Address - Street 1:95 LEONARD AVENUE
Practice Address - Street 2:BUILDING 2 2ND FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301
Practice Address - Country:US
Practice Address - Phone:724-223-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT018307207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine