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NPI Code Detail

MEDICARE: DR. TERESA M LANIER MD PHD

MEDICARE: DR. TERESA M LANIER MD PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD165194OR
2207Q00000XFamily Medicine PhysicianAZ26887AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104865658
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERESA M LANIER MD PHD
Provider Business Mailing Address
First Line : 1900 WOODLAND DR
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2099
Country : US
Telephone Number : 541-267-5151
Fax Number :
Provider Business Practice Location Address
First Line : 1900 WOODLAND DR
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2099
Country : US
Telephone Number : 541-267-5151
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 12/05/2023

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Directions to “ DR. TERESA M LANIER MD PHD” Practice Location

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