Provider Demographics
NPI:1063460830
Name:LANCHBURY, FORREST D (MD)
Entity Type:Individual
Prefix:MR
First Name:FORREST
Middle Name:D
Last Name:LANCHBURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 COVE PKWY
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-5332
Mailing Address - Country:US
Mailing Address - Phone:701-440-8434
Mailing Address - Fax:
Practice Address - Street 1:210 SUNSET DR STE A1
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5409
Practice Address - Country:US
Practice Address - Phone:928-282-2520
Practice Address - Fax:928-282-2895
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ51505208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice