Provider Demographics
NPI:1427006105
Name:GEE-GOTT, LANA (MD)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:GEE-GOTT
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 1:2280 MARCOLA RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-2594
Mailing Address - Country:US
Mailing Address - Phone:541-747-8576
Mailing Address - Fax:541-747-0655
Practice Address - Street 1:2280 MARCOLA RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-2594
Practice Address - Country:US
Practice Address - Phone:541-747-8576
Practice Address - Fax:541-747-0655
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27054207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR278484Medicaid
ORH42333Medicare UPIN
OR136110Medicare PIN