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General NPI Number Information
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NPI Number | 1720172059
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Entity Type | Individual
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Provider Name | THEODORE CLIFFORD NING JR. MD
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/27/2021
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Provider Practice Location Address
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Address Line | 400 INDIANA ST SUITE 300
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City | GOLDEN
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State | CO
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Zip | 80401-5027
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Country | US
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Telephone | 303-885-2550
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Fax |
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Provider Business Mailing Address
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Address Line | 33424 DEEP FOREST RD
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City | EVERGREEN
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State | CO
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Zip | 80439-9736
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Country | US
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Telephone | 303-670-7171
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 16283
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 042.0012859
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | DR.0016283
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License Number State | CO
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