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Individual

DR. CRAIG PHILLIP LANCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
301 E MIEL DE LUNA AVE, TUCUMCARI, NM 88401-3810
(800) 841-4236
Mailing address
PO BOX 3212, INDIANAPOLIS, IN 46206-3212

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD2017-0486
NM
2085R0204X
Vascular & Interventional Radiology Physician
MT210197
PA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/31/2011
Last updated
03/17/2018
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