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General NPI Number Information
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NPI Number | 1265436786
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Entity Type | Individual
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Provider Name | RICHARD D MOUNTAIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2005
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 499 E HAMPDEN AVE STE 300
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City | ENGLEWOOD
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State | CO
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Zip | 80113-2793
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Country | US
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Telephone | 303-788-8500
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Fax | 303-788-8505
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Provider Business Mailing Address
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Address Line | 1400 JACKSON ST
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City | DENVER
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State | CO
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Zip | 80206-2761
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Country | US
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Telephone | 303-388-4461
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Fax | 303-270-2174
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 21788
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 21788
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License Number State | CO
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