Healthcare Provider Details

I. General information

NPI: 1679534788
Provider Name (Legal Business Name): TIMOTHY CREANY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 11/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14062 DENVER WEST PKWY BLDG 52 STE 150
LAKEWOOD CO
80401-3187
US

IV. Provider business mailing address

14062 DENVER WEST PKWY BLDG 52 STE 150
LAKEWOOD CO
80401-3187
US

V. Phone/Fax

Practice location:
  • Phone: 303-893-8300
  • Fax: 303-825-7927
Mailing address:
  • Phone: 303-893-8300
  • Fax: 303-825-7927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number37786
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.0037786
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: