Healthcare Provider Details

I. General information

NPI: 1447462510
Provider Name (Legal Business Name): RICHARD J FLANIGAN MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 01/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 E ILIFF AVE
DENVER CO
80222-6025
US

IV. Provider business mailing address

8055 E TUFTS AVE STE 230
DENVER CO
80237-2854
US

V. Phone/Fax

Practice location:
  • Phone: 303-584-8900
  • Fax: 720-524-9475
Mailing address:
  • Phone: 303-357-2559
  • Fax: 720-572-5112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number18128
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberDR.0018128
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.0018128
License Number StateCO

VIII. Authorized Official

Name: CANDICE R CHACON-JARAMILLO
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 720-439-2456