Provider Demographics
NPI:1447311287
Name:LIFTON, LLOYD B (MD)
Entity type:Individual
Prefix:DR
First Name:LLOYD
Middle Name:B
Last Name:LIFTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15000
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81302-8901
Mailing Address - Country:US
Mailing Address - Phone:970-259-2525
Mailing Address - Fax:
Practice Address - Street 1:575 RIVERGATE UNIT 207
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7490
Practice Address - Country:US
Practice Address - Phone:970-259-0701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24321207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01243211Medicaid
NMU6177Medicaid
NMU6177Medicaid
COC53861Medicare PIN
CO01243211Medicaid
COD24431Medicare UPIN