Healthcare Provider Details

I. General information

NPI: 1972522688
Provider Name (Legal Business Name): DAVID C LONGCOPE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 HALE PKWY SUITE 430
DENVER CO
80220-4020
US

IV. Provider business mailing address

8490 E CRESCENT PKWY STE 380
GREENWOOD VILLAGE CO
80111-2815
US

V. Phone/Fax

Practice location:
  • Phone: 303-377-6401
  • Fax: 303-377-6951
Mailing address:
  • Phone: 303-957-1310
  • Fax: 303-761-4252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number44105
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: