MEDICARE: WALTER B VERNON MD

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	208600000X	Surgery Physician	31476	CO

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	:	1013005024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WALTER B VERNON MD

Provider Business Mailing Address
First Line	:	8490 E CRESCENT PKWY STE 380
Second Line	:
City	:	GREENWOOD VILLAGE
State	:	CO
Zip	:	80111-2815
Country	:	US
Telephone Number	:	303-957-1310
Fax Number	:	303-761-4252

Provider Business Practice Location Address
First Line	:	1601 E 19TH AVE STE 4600
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80218-1289
Country	:	US
Telephone Number	:	303-952-2300
Fax Number	:

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	11/19/2024

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