MEDICARE: JULIE A LANTER PA-C

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	363A00000X	Physician Assistant	50.001643	OH

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	:	1699775551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE A LANTER PA-C

Provider Business Mailing Address
First Line	:	2818 MACK RD
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5130
Country	:	US
Telephone Number	:	513-900-0750
Fax Number	:	513-816-7631

Provider Business Practice Location Address
First Line	:	2818 MACK RD
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5130
Country	:	US
Telephone Number	:	513-900-0750
Fax Number	:	513-816-7631

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	05/20/2016

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Directions to “ JULIE A LANTER PA-C” Practice Location

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