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General NPI Number Information
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NPI Number | 1164929311
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Entity Type | Individual
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Provider Name | JEFFREY WAYNE LANTZ JR. DO
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Gender | Male
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Dates
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Enumeration Date | 04/12/2018
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 1900 ELECTRIC RD
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City | SALEM
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State | VA
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Zip | 24153-7474
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Country | US
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Telephone | 540-774-8660
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Fax | 540-774-9195
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Provider Business Mailing Address
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Address Line | 2013 JEFFERSON ST SW FL 2
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City | ROANOKE
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State | VA
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Zip | 24014-2419
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Country | US
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Telephone | 540-982-0237
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Fax | 540-982-2719
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 0102207268
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0102207268
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2021-01001
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License Number State | NC
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