Basic Information
Provider Information
NPI: 1699882977
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHLECHT
FirstName: LORNE
MiddleName: P
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4800 N 22ND ST
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850164701
CountryCode: US
TelephoneNumber: 6029551000
FaxNumber: 6025084830
Practice Location
Address1: 40 CAPRI BLVD STE 102
Address2:  
City: LAKE HAVASU CITY
State: AZ
PostalCode: 864035661
CountryCode: US
TelephoneNumber: 6029551000
FaxNumber: 6025084830
Other Information
ProviderEnumerationDate: 08/24/2006
LastUpdateDate: 05/07/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207W00000X50866AZN Allopathic & Osteopathic PhysiciansOphthalmology 
207W00000X32228MNN Allopathic & Osteopathic PhysiciansOphthalmology 
207W00000X32143WIN Allopathic & Osteopathic PhysiciansOphthalmology 
207WX0009X50866AZN    
207WX0120X50866AZN    
207WX0200X50866AZY    

ID Information
IDTypeStateIssuerDescription
04532105AZ MEDICAID


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