Individual
DR. BETTY J LASICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 MERCADO STREET, SUITE 105, DURANGO, CO 81301-7311
(970) 382-8800
(970) 382-0122
Mailing address
1 MERCADO STREET, SUITE 105, DURANGO, CO 81301-7311
(970) 382-8800
(970) 382-0122
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
41535
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568420255
NPI
CO
05
—
32451873
—
CO
05
—
67772021
—
NM
Enumeration date
05/02/2006
Last updated
03/08/2021
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