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General NPI Number Information
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NPI Number | 1407950108
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Entity Type | Individual
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Provider Name | GEORGE J. POGGIOLI JR. M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 03/20/2014
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Provider Practice Location Address
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Address Line | 13111 E BRIARWOOD AVE 305
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City | CENTENNIAL
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State | CO
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Zip | 80112-3930
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Country | US
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Telephone | 720-279-1388
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Fax | 720-249-0219
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Provider Business Mailing Address
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Address Line | PO BOX 3277
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City | ENGLEWOOD
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State | CO
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Zip | 80155-3277
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Country | US
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Telephone | 720-279-1388
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Fax | 720-249-0219
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 45436
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License Number State | CO
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