Provider Demographics
NPI:1487637286
Name:BECKER, LISA A (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:A
Last Name:BECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7720 S BROADWAY
Mailing Address - Street 2:STE 220
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2632
Mailing Address - Country:US
Mailing Address - Phone:720-528-0800
Mailing Address - Fax:720-528-0801
Practice Address - Street 1:7720 S BROADWAY
Practice Address - Street 2:STE 220
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2632
Practice Address - Country:US
Practice Address - Phone:720-528-0800
Practice Address - Fax:720-528-0801
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35769207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01357698Medicaid
G49517Medicare UPIN
0700187Medicare ID - Type Unspecified
CO01357698Medicaid