Healthcare Provider Details

I. General information

NPI: 1568456127
Provider Name (Legal Business Name): VANCE J BRAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7111 E LOWRY BLVD STE 200
DENVER CO
80230-7360
US

IV. Provider business mailing address

7111 E LOWRY BLVD STE 200
DENVER CO
80230-7360
US

V. Phone/Fax

Practice location:
  • Phone: 303-394-2828
  • Fax: 303-320-0242
Mailing address:
  • Phone: 303-394-2828
  • Fax: 303-320-0242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number29019
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: