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General NPI Number Information
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NPI Number | 1629035266
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Entity Type | Individual
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Provider Name | JUDY C BAACK MD
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Gender | Female
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10099 RIDGE GATE PKWY #290
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City | LONE TREE
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State | CO
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Zip | 80124
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Country | US
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Telephone | 303-791-2112
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Fax | 303-683-6415
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Provider Business Mailing Address
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Address Line | PO BOX 261577
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City | LITTLETON
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State | CO
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Zip | 80163-1577
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 31755
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License Number State | CO
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