Healthcare Provider Details

I. General information

NPI: 1982753356
Provider Name (Legal Business Name): ANDREW MCADOO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 RUSH DR
SALIDA CO
81201-9627
US

IV. Provider business mailing address

PO BOX 7704
LOVELAND CO
80537-0704
US

V. Phone/Fax

Practice location:
  • Phone: 719-530-2200
  • Fax: 970-667-0847
Mailing address:
  • Phone: 970-663-2742
  • Fax: 970-667-0847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4098
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number05-32677
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberDR.0058423
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: