Individual
ERIC J LANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
24084
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300008944
RAILROAD MEDICARE
MN
05
—
35233700
—
WI
05
—
699820800
—
MN
05
—
ENROLLED
—
IA
Enumeration date
12/21/2005
Last updated
03/08/2010
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