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Individual

DR. GARY A LAMOTTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1397 WEIMER RD, TAOS, NM 87571-6253
(575) 758-8883
(303) 468-1394
Mailing address
12687 W CEDAR DR, 200, LAKEWOOD, CO 80228-2014
(303) 468-1395
(303) 468-1394

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
22047
NE
2085R0202X
Diagnostic Radiology Physician
28061
CO
2085R0202X
Diagnostic Radiology Physician
Primary
84-209
NM
2085R0202X
Diagnostic Radiology Physician
G5279
TX
2085R0204X
Vascular & Interventional Radiology Physician
84-209
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000W6165
NM
01
0255069
DOL WASHINGTON
WA
01
0259639
DOL WA RIN
WA
05
10025709000
NE
05
1447247994
WY
05
1447247994/7726790
SD
01
P00720336
RR MCR NE
NE
Enumeration date
09/30/2005
Last updated
01/15/2020
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