Healthcare Provider Details

I. General information

NPI: 1316154248
Provider Name (Legal Business Name): SCOTT E. LYLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF COLORADO SCHOOL OF MEDICINE 4200 E. 9TH AVE.,
DENVER CO
80262-0001
US

IV. Provider business mailing address

UNIVERSITY OF COLORADO SCHOOL OF MEDICINE 4200 E. 9TH AVE.,
DENVER CO
80262-0001
US

V. Phone/Fax

Practice location:
  • Phone: 303-315-7424
  • Fax:
Mailing address:
  • Phone: 303-315-7424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2296
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: