Healthcare Provider Details

I. General information

NPI: 1245344431
Provider Name (Legal Business Name): LINCOLN PAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 OLD LARAMIE TRL
LAFAYETTE CO
80026-7012
US

IV. Provider business mailing address

6227 FLORENCE WAY
DENVER CO
80238-4379
US

V. Phone/Fax

Practice location:
  • Phone: 720-457-8383
  • Fax:
Mailing address:
  • Phone: 914-238-1200
  • Fax: 914-238-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number183421
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberDR.0067105
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35.074278
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: