Healthcare Provider Details

I. General information

NPI: 1538796859
Provider Name (Legal Business Name): AUSTIN G. MCCUISTION MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13123 E 16TH AVE
AURORA CO
80045-7106
US

IV. Provider business mailing address

13123 E 16TH AVE
AURORA CO
80045-7106
US

V. Phone/Fax

Practice location:
  • Phone: 720-777-6263
  • Fax: 720-777-7200
Mailing address:
  • Phone: 207-777-6263
  • Fax: 720-777-7200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR.0070992
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: