Healthcare Provider Details

I. General information

NPI: 1154389443
Provider Name (Legal Business Name): JOSEPH EDWARD MECHANIK DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7180 E ORCHARD RD STE 100
CENTENNIAL CO
80111
US

IV. Provider business mailing address

7180 E ORCHARD RD STE 100
CENTENNIAL CO
80111-1725
US

V. Phone/Fax

Practice location:
  • Phone: 303-333-3383
  • Fax: 844-793-4262
Mailing address:
  • Phone: 303-333-3383
  • Fax: 844-793-4262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number527
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number527
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: