Healthcare Provider Details

I. General information

NPI: 1386649903
Provider Name (Legal Business Name): BARBARA LYNN GABLEHOUSE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 02/07/2020
Certification Date: 02/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 LUTHERAN PKWY STE 340
WHEAT RIDGE CO
80033-6039
US

IV. Provider business mailing address

3555 LUTHERAN PKWY STE 340
WHEAT RIDGE CO
80033-6039
US

V. Phone/Fax

Practice location:
  • Phone: 303-996-6005
  • Fax: 303-421-3822
Mailing address:
  • Phone: 303-996-6005
  • Fax: 303-421-3822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number29927
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01299270
Identifier TypeMEDICAID
Identifier StateCO
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: