Individual
DR. LANE M FAIRBAIRN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45120
CO
390200000X
Student in an Organized Health Care Education/Training Program
TL-1735
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019158
KAISER COMMERCIAL NUMBER
CO
05
—
81401272
—
CO
Enumeration date
01/26/2007
Last updated
06/12/2021
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