Provider Demographics
NPI:1528004363
Name:ROBERT D. LANCASTER, MD, PC
Entity Type:Organization
Organization Name:ROBERT D. LANCASTER, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:LANCASTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-982-4431
Mailing Address - Street 1:2421 S. RAINBOWS END
Mailing Address - Street 2:
Mailing Address - City:GOLD CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:85118-4891
Mailing Address - Country:US
Mailing Address - Phone:480-982-4431
Mailing Address - Fax:480-671-0140
Practice Address - Street 1:2421 S. RAINBOWS END
Practice Address - Street 2:
Practice Address - City:GOLD CANYON
Practice Address - State:AZ
Practice Address - Zip Code:85118-4891
Practice Address - Country:US
Practice Address - Phone:480-982-4431
Practice Address - Fax:480-671-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0834172-0207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ110127Medicare PIN
AZE95194Medicare UPIN