Basic Information
Provider Information
NPI: 1083678957
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHATZ
FirstName: LISA
MiddleName: SHAWN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4545 E 9TH AVE
Address2: 460
City: DENVER
State: CO
PostalCode: 802203901
CountryCode: US
TelephoneNumber: 3033882922
FaxNumber: 3033882962
Practice Location
Address1: 4545 E 9TH AVE STE 460
Address2:  
City: DENVER
State: CO
PostalCode: 802203904
CountryCode: US
TelephoneNumber: 3033882922
FaxNumber: 3033882962
Other Information
ProviderEnumerationDate: 04/17/2006
LastUpdateDate: 01/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XDR.0039605CON Allopathic & Osteopathic PhysiciansSurgery 
208C00000XDR.0039605COY Allopathic & Osteopathic PhysiciansColon & Rectal Surgery 

No ID Information.


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