Healthcare Provider Details

I. General information

NPI: 1962701433
Provider Name (Legal Business Name): STEPHEN MEEKER RRA RT(R) (CT) RPA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2011
Last Update Date: 03/29/2024
Certification Date: 03/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10800 E GEDDES AVE STE 300
ENGLEWOOD CO
80112-3895
US

IV. Provider business mailing address

10800 E GEDDES AVE STE 300
ENGLEWOOD CO
80112-3895
US

V. Phone/Fax

Practice location:
  • Phone: 303-761-9190
  • Fax:
Mailing address:
  • Phone: 303-761-9190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code243U00000X
TaxonomyRadiology Practitioner Assistant
License Number10 CO 1406
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: