Provider Demographics
NPI:1275646077
Name:LENAHAN, DEBORAH S (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:LENAHAN
Suffix:
Gender:F
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:P.O. BOX 10700
Mailing Address - Street 2:3150 N 12TH ST
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81502
Mailing Address - Country:US
Mailing Address - Phone:970-254-4600
Mailing Address - Fax:970-254-4601
Practice Address - Street 1:3150 N 12TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506
Practice Address - Country:US
Practice Address - Phone:970-254-4600
Practice Address - Fax:970-254-4601
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38588207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO89631234Medicaid
AL8834497OtherDEA
66194Medicare ID - Type Unspecified
CO89631234Medicaid