Healthcare Provider Details
I. General information
NPI: 1245327089
Provider Name (Legal Business Name): JOSE M BARRIOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/05/2006
Last Update Date: 09/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9224 TEDDY LN SUITE 220
LONETREE CO
80124-6798
US
IV. Provider business mailing address
9224 TEDDY LANE #220
LONE TREE CO
80124-6798
US
V. Phone/Fax
- Phone: 303-869-2121
- Fax: 303-869-2266
- Phone: 303-790-1515
- Fax: 303-790-1989
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0206X |
| Taxonomy | Pediatric Gastroenterology Physician |
| License Number | 39480 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: