Provider Demographics
NPI:1881687432
Name:FORSTOT, STEPHAN LANCE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHAN
Middle Name:LANCE
Last Name:FORSTOT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1501 W MINERAL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5716
Mailing Address - Country:US
Mailing Address - Phone:303-730-0404
Mailing Address - Fax:720-647-4210
Practice Address - Street 1:1501 W MINERAL AVE STE 100
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5716
Practice Address - Country:US
Practice Address - Phone:303-730-0404
Practice Address - Fax:720-647-4210
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2024-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO20155207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01201557Medicaid
180014204OtherRAILROAD MEDICARE
FOB4528OtherBLUE CROSS BLUE SHIELD
920683020788OtherBLOCK VISION EYE SPECIALI
FOB4528OtherBLUE CROSS BLUE SHIELD
180014204OtherRAILROAD MEDICARE