Provider Demographics
NPI:1801852165
Name:LOTT, DANIEL LAWRENCE (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LAWRENCE
Last Name:LOTT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 PINTO LN STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4007
Mailing Address - Country:US
Mailing Address - Phone:703-380-7050
Mailing Address - Fax:703-215-9740
Practice Address - Street 1:2011 PINTO LN STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4007
Practice Address - Country:US
Practice Address - Phone:703-380-7050
Practice Address - Fax:703-215-9740
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO1938207V00000X
IN02003163A207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000513878OtherANTHEM BCBS
INBL6475037OtherDEA
IN200851570Medicaid
IN15D1003624OtherCLIA
KY7100010900Medicaid
INP00390584OtherRAILROAD MEDICARE
INBL6475037OtherDEA
KY7100010900Medicaid