Individual
DR. MARY BETH LANSING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
90 HEALTH PARK DR, SUITE 100, LOUISVILLE, CO 80027-9757
(303) 666-1800
(303) 666-8830
Mailing address
90 HEALTH PARK DR, SUITE 100, LOUISVILLE, CO 80027-9757
(303) 666-1800
(303) 666-8830
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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