Healthcare Provider Details

I. General information

NPI: 1700360047
Provider Name (Legal Business Name): ROBERT EUGENE LAMMERS JR. PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2018
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 BRIGHTON BLVD
DENVER CO
80216-3625
US

IV. Provider business mailing address

1598 COUNTY ROAD 59
KEENESBURG CO
80643-9424
US

V. Phone/Fax

Practice location:
  • Phone: 303-299-4528
  • Fax:
Mailing address:
  • Phone: 601-466-9595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA00437
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA0008683
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: