Healthcare Provider Details

I. General information

NPI: 1811176688
Provider Name (Legal Business Name): PREFERRED PROVIDER SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2007
Last Update Date: 05/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 S QUEBEC ST STE A3-313
CENTENNIAL CO
80112-4411
US

IV. Provider business mailing address

8200 S QUEBEC ST STE A3-313
CENTENNIAL CO
80112-4411
US

V. Phone/Fax

Practice location:
  • Phone: 303-481-7030
  • Fax: 303-745-7942
Mailing address:
  • Phone: 303-481-7030
  • Fax: 303-745-7942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BOBBIE JO LIVINGSTON
Title or Position: OWNER
Credential: M.D.
Phone: 303-481-7030