Provider Demographics
NPI:1114136686
Name:LANCASTER, DAVID GEORGE (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GEORGE
Last Name:LANCASTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1107
Mailing Address - Street 2:1432 SOUTHWEST BLVD
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65102-1107
Mailing Address - Country:US
Mailing Address - Phone:573-632-5660
Mailing Address - Fax:573-632-5859
Practice Address - Street 1:1432 SOUTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-2444
Practice Address - Country:US
Practice Address - Phone:573-632-5660
Practice Address - Fax:573-632-5859
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010030852208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation