Provider Demographics
NPI:1972529113
Name:LAMOND, RODERICK G (MD)
Entity Type:Individual
Prefix:
First Name:RODERICK
Middle Name:G
Last Name:LAMOND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-854-3710
Mailing Address - Fax:303-252-9075
Practice Address - Street 1:777 E SPEER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-4263
Practice Address - Country:US
Practice Address - Phone:303-854-3710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33002207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01330026Medicaid
COCO306723Medicare PIN
CO384438ZSDMMedicare PIN
CO01330026Medicaid