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Individual

JOHN STEVE LAVENGOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1970 E 3RD AVE # UNTIL1, DURANGO, CO 81301-5056
(970) 335-2288
(970) 335-2280
Mailing address
PO BOX 1328, DURANGO, CO 81302-1328
(970) 335-2314

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28293
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01282938
CO
Enumeration date
01/18/2007
Last updated
12/06/2021
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