Provider Demographics
NPI:1245827476
Name:RATIONAL DERMATOLOGY, PC
Entity type:Organization
Organization Name:RATIONAL DERMATOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:LANTZY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-531-5400
Mailing Address - Street 1:1220 LAKE PLAZA DR STE 100
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3548
Mailing Address - Country:US
Mailing Address - Phone:719-531-5400
Mailing Address - Fax:719-896-4971
Practice Address - Street 1:1220 LAKE PLAZA DR STE 100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3548
Practice Address - Country:US
Practice Address - Phone:719-531-5400
Practice Address - Fax:719-896-4971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty