Healthcare Provider Details
I. General information
NPI: 1477534154
Provider Name (Legal Business Name): JOSEPH LADIKA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/09/2005
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3235 MILL VISTA RD
HIGHLANDS RANCH CO
80129-2440
US
IV. Provider business mailing address
5730 EXECUTIVE DR STE 230
CATONSVILLE MD
21228-1762
US
V. Phone/Fax
- Phone: 303-876-8320
- Fax:
- Phone: 303-876-8320
- Fax: 888-701-4175
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 173000000X |
| Taxonomy | Legal Medicine |
| License Number | 37159 |
| License Number State | CO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 37159 |
| License Number State | CO |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | DR.0037159 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: