Provider Demographics
NPI:1750370003
Name:BOOK, LORI D (MD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:D
Last Name:BOOK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 MEDICAL CENTER PT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-8731
Mailing Address - Country:US
Mailing Address - Phone:719-630-3276
Mailing Address - Fax:719-635-5804
Practice Address - Street 1:1625 MEDICAL CENTER PT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8731
Practice Address - Country:US
Practice Address - Phone:719-630-3276
Practice Address - Fax:719-635-5804
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42508207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO11251321Medicaid
CO528618Medicare ID - Type Unspecified
COIO3368Medicare UPIN