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NPI Code Detail

MEDICARE: DAVID W. DIRKS MD

MEDICARE: DAVID W. DIRKS 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
1207Q00000XFamily Medicine Physician20736CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871576561
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID W. DIRKS MD
Provider Business Mailing Address
First Line : 3150 N 12TH ST
Second Line : PO BOX 10700
City : GRAND JUNCTION
State : CO
Zip : 81506-2863
Country : US
Telephone Number : 970-245-1220
Fax Number : 970-245-9148
Provider Business Practice Location Address
First Line : 3150 N 12TH ST
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81506-2863
Country : US
Telephone Number : 970-245-1220
Fax Number : 970-245-9148
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2005
Last Update Date : 11/08/2013

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Directions to “ DAVID W. DIRKS MD” Practice Location

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