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General NPI Number Information
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NPI Number | 1467764498
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Entity Type | Individual
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Provider Name | TODD MICHAEL JAMES D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2010
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Last Update Date | 04/01/2021
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Provider Practice Location Address
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Address Line | 2373 G RD STE 280
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City | GRAND JCT
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State | CO
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Zip | 81505-1006
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Country | US
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Telephone | 970-644-4030
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Fax | 970-644-3914
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Provider Business Mailing Address
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Address Line | PO BOX 1727
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City | GRAND JCT
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State | CO
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Zip | 81502-1727
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Country | US
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Telephone | 970-644-4030
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Fax | 970-644-3914
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 7205
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | DR.0065812
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License Number State | CO
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