MEDICARE: ROBIN L LANNAN M.D.

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	207R00000X	Internal Medicine Physician	MD16225	OR

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

General Provider Information

NPI Number	:	1467401273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN L LANNAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 5579
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97708-5579
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 NE NEFF RD
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-6337
Country	:	US
Telephone Number	:	541-706-3700
Fax Number	:

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

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	06/07/2017

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