Healthcare Provider Details

I. General information

NPI: 1194142166
Provider Name (Legal Business Name): WESLEY PRICHARD D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 06/06/2023
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13952 DENVER WEST PKWY STE 100
LAKEWOOD CO
80401-3141
US

IV. Provider business mailing address

382 S ARTHUR AVE
LOUISVILLE CO
80027-3094
US

V. Phone/Fax

Practice location:
  • Phone: 303-604-5000
  • Fax:
Mailing address:
  • Phone: 303-604-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberDR.0065551
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberOS018709
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: