Provider Demographics
NPI:1205824182
Name:LANE, LARA M (MD)
Entity type:Individual
Prefix:MRS
First Name:LARA
Middle Name:M
Last Name:LANE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-325-2185
Mailing Address - Fax:303-790-0938
Practice Address - Street 1:10099 RIDGEGATE PKWY
Practice Address - Street 2:#280
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5531
Practice Address - Country:US
Practice Address - Phone:303-325-2185
Practice Address - Fax:303-790-0938
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2022-01-31
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Provider Licenses
StateLicense IDTaxonomies
CO38525207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO72702087Medicaid
COC807641Medicare PIN
COG95812Medicare UPIN
CO72702087Medicaid