=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326058215
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DRS CLEVELAND & HUTCHISON PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/09/2006
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2460 W 26TH AVENUE 420 C
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80211-5308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-480-3565
-----------------------------------------------------
Fax | 303-480-5066
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2460 W 26TH AVENUE 420 C
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80211-5308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-480-3565
-----------------------------------------------------
Fax | 303-480-5066
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | DAVID D BECK
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 303-480-3565
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | TAX ID
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------