=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154389443
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSEPH EDWARD MECHANIK DPM
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/03/2006
-----------------------------------------------------
Last Update Date | 10/16/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7180 E ORCHARD RD STE 100
-----------------------------------------------------
City | CENTENNIAL
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-333-3383
-----------------------------------------------------
Fax | 844-793-4262
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7180 E ORCHARD RD STE 100
-----------------------------------------------------
City | CENTENNIAL
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80111-1725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-333-3383
-----------------------------------------------------
Fax | 844-793-4262
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0000X
-----------------------------------------------------
Taxonomy Name | Sports Medicine Podiatrist
-----------------------------------------------------
License Number | 527
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | 527
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------