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General NPI Number Information
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NPI Number | 1508979519
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Entity Type | Individual
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Provider Name | DOUGLAS MARK IKELHEIMER MD
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Gender | Male
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 777 BANNOCK ST MC 7782
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City | DENVER
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State | CO
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Zip | 80204-4507
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Country | US
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Telephone | 303-436-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 777 BANNOCK ST MC 7782
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City | DENVER
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State | CO
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Zip | 80204-4507
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Country | US
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Telephone |
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C163816
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | MD453478
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 036136893
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD453478
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036136893
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | 0101259575
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License Number State | VA
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Taxonomy #7
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101259575
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License Number State | VA
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Taxonomy #8
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 40353
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License Number State | CO
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Taxonomy #9
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C1-0011239
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License Number State | DE
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Taxonomy #10
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 76822
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License Number State | WI
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