Healthcare Provider Details

I. General information

NPI: 1770534919
Provider Name (Legal Business Name): LANCE P STEAHLY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2132 BIRDIE DR
MILLIKEN CO
80543-9637
US

IV. Provider business mailing address

2132 BIRDIE DR
MILLIKEN CO
80543-9637
US

V. Phone/Fax

Practice location:
  • Phone: 719-494-3512
  • Fax:
Mailing address:
  • Phone: 719-494-3512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number036072708
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: