MEDICARE: JOHN C RICCIO 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	207P00000X	Emergency Medicine Physician	26946	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	930020349	OTHER	CO	RR MEDICARE

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	:	1164497079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN C RICCIO MD

Provider Business Mailing Address
First Line	:	1241 WEST MINERAL AVENUE
Second Line	:	SUITE 100
City	:	LITTLETON
State	:	CO
Zip	:	80120-5685
Country	:	US
Telephone Number	:	303-759-0854
Fax Number	:	303-759-0864

Provider Business Practice Location Address
First Line	:	2525 SOUTH DOWNING STREET
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-5817
Country	:	US
Telephone Number	:	303-778-5666
Fax Number	:	303-778-5787

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	04/23/2009

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Directions to “ JOHN C RICCIO MD” Practice Location

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