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General NPI Number Information
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NPI Number | 1346277001
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Entity Type | Individual
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Provider Name | ROBERT B BRICCA MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1 MERCADO ST STE 160
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City | DURANGO
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State | CO
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Zip | 81301-7309
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Country | US
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Telephone | 970-385-9850
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Fax | 970-385-9854
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Provider Business Mailing Address
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Address Line | 1 MERCADO ST STE 160
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City | DURANGO
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State | CO
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Zip | 81301-7309
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Country | US
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Telephone | 970-385-9850
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Fax | 970-385-9854
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 44129
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0044129
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License Number State | CO
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