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General NPI Number Information
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NPI Number | 1568409654
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Entity Type | Individual
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Provider Name | RICKY L ARTIST MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 12/18/2013
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Provider Practice Location Address
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Address Line | 2803 ROSLYN ST
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City | DENVER
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State | CO
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Zip | 80238-2624
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Country | US
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Telephone | 303-403-6300
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Fax | 303-403-6315
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Provider Business Mailing Address
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Address Line | 500 ELDORADO BLVD STE 6250
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City | BROOMFIELD
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State | CO
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Zip | 80021-3421
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Country | US
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Telephone | 303-272-0768
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Fax | 303-318-2488
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25174
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License Number State | CO
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