MEDICARE: MARK LANDT D.O.

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
1	207L00000X	Anesthesiology Physician	34-00-3644	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000024299	OTHER	OH	ANTHEM PIN#
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	20-00775	OTHER	OH	UNHC PIN#
4	050045148	OTHER	OH	TRAVELERS PIN#

General Provider Information

NPI Number	:	1477558856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK LANDT D.O.

Provider Business Mailing Address
First Line	:	PO BOX 722
Second Line	:
City	:	EDWARDS
State	:	CO
Zip	:	81632-0722
Country	:	US
Telephone Number	:	970-926-5702
Fax Number	:	970-926-5702

Provider Business Practice Location Address
First Line	:	37 ELK PLACE
Second Line	:
City	:	EDWARDS
State	:	CO
Zip	:	81632-0722
Country	:	US
Telephone Number	:	970-926-5702
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	03/20/2015

Similar Medicare Providers

1336142793 — DR. JONATHAN DANIEL OWENS OD
Practice Location Address:

1140 EDWARDS VILLAGE BLVD. , B-206
EDWARDS, CO
81632

Practice Phone: 970-926-8474
Practice Fax: 970-926-3634

1285632539 — EAGLE COUNTY HEALTH SERVICE DISTRICT
Practice Location Address:

1055 EDWARDS VILLAGE BLVD
EDWARDS, CO
81632-8196

Practice Phone: 970-926-5270
Practice Fax: 970-436-4105

1215921481 — MR. MICHAEL JAMES GRANZIN PT
Practice Location Address:

320 BEARD CREEK RD
EDWARDS, CO
81632-6426

Practice Phone: 970-569-7770
Practice Fax:

1215924279 — JULIE PETERSON PT
Practice Location Address:

1140 EDWARDS VILLAGE BLVD B208
EDWARDS, CO
81632-4828

Practice Phone: 970-569-3883
Practice Fax: 970-569-3884

1104808096 — KATIE JONES FNP
Practice Location Address:

322 BEARD CREEK RD
EDWARDS, CO
81632-6433

Practice Phone: 970-476-2451
Practice Fax:

1992782874 — DR. BARRY IRA SANDLER DO
Practice Location Address:

439 EDWARDS ACCESS RD # B204
EDWARDS, CO
81632-5634

Practice Phone: 970-445-2489
Practice Fax: 970-470-6510

Directions to “ MARK LANDT D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.