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1447247994

NPI Code Detail

MEDICARE: DR. GARY A LAMOTTE MD

MEDICARE: DR. GARY A LAMOTTE MD

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	2085R0202X	Diagnostic Radiology Physician	22047	NE
2	2085R0202X	Diagnostic Radiology Physician	G5279	TX
3	2085R0202X	Diagnostic Radiology Physician	28061	CO
4	2085R0204X	Vascular & Interventional Radiology Physician	84-209	NM
5	2085R0202X	Diagnostic Radiology Physician	84-209	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	P00720336	OTHER	NE	RR MCR NE
3	0255069	OTHER	WA	DOL WASHINGTON
4	0259639	OTHER	WA	DOL WA RIN
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447247994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY A LAMOTTE MD

Provider Business Mailing Address
First Line	:	12687 W CEDAR DR
Second Line	:	200
City	:	LAKEWOOD
State	:	CO
Zip	:	80228-2014
Country	:	US
Telephone Number	:	303-468-1395
Fax Number	:	303-468-1394

Provider Business Practice Location Address
First Line	:	1397 WEIMER RD
Second Line	:
City	:	TAOS
State	:	NM
Zip	:	87571-6253
Country	:	US
Telephone Number	:	575-758-8883
Fax Number	:	303-468-1394

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	01/15/2020

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Directions to “ DR. GARY A LAMOTTE MD” 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.

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