Healthcare Provider Details

I. General information

NPI: 1558315986
Provider Name (Legal Business Name): JAMES SBARBARO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 E ORMAN AVE SUITE A640
PUEBLO CO
81004-3537
US

IV. Provider business mailing address

1925 E ORMAN AVE SUITE A640
PUEBLO CO
81004-3537
US

V. Phone/Fax

Practice location:
  • Phone: 719-564-1544
  • Fax: 719-565-2657
Mailing address:
  • Phone: 719-564-1544
  • Fax: 719-565-2657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number24835
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: