Individual
JERI L LANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3 RIVERSIDE CIR, ROANOKE, VA 24016-4955
(540) 224-5170
(540) 772-8219
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101231311
VA
208000000X
Pediatrics Physician
0101231311
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005863147
—
VA
05
—
005863155
—
VA
05
—
005863538
—
VA
05
—
005885981
—
VA
05
—
1306828876
—
VA
Enumeration date
11/18/2005
Last updated
02/29/2024
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