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Individual
DR. MARY BETH LANSING
Active
Individual
DR. MARY BETH LANSING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
36103
CO
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
36103
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01361039
—
CO
01
—
C51901
MEDICARE ID
CO
01
—
C811156
MEDICARE PTAN
CO
Enumeration date
10/31/2005
Last updated
04/29/2021
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