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General NPI Number Information
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NPI Number | 1710474952
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Entity Type | Individual
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Provider Name | IAN ALEXANDER BACKLUND MD
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Gender | Male
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Dates
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Enumeration Date | 04/13/2018
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 660 BANNOCK ST
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City | DENVER
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State | CO
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Zip | 80204-4506
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Country | US
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Telephone | 303-436-4949
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Fax | 303-602-4560
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Provider Business Mailing Address
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Address Line | 1215 LEE ST # 801016
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22908-0816
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Country | US
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Telephone | 434-243-0270
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Fax | 434-243-0290
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 1710474952
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | DR.0070122
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License Number State | CO
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