Healthcare Provider Details

I. General information

NPI: 1215045133
Provider Name (Legal Business Name): ANDREW W PARKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 06/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 E.HALE PKWY STE 550
DENVER CO
80220-4053
US

IV. Provider business mailing address

4700 E.HALE PKWY STE 550
DENVER CO
80220-4053
US

V. Phone/Fax

Practice location:
  • Phone: 303-321-6600
  • Fax:
Mailing address:
  • Phone: 303-321-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number31796
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: