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General NPI Number Information
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NPI Number | 1902071202
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Entity Type | Individual
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Provider Name | MICHAEL WILLIAM NOONAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 203 S ROLLIE AVE
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City | FORT LUPTON
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State | CO
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Zip | 80621-1508
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Country | US
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Telephone | 303-286-4560
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Fax | 303-286-4589
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Provider Business Mailing Address
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Address Line | 6255 QUEBEC PKWY
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City | COMMERCE CITY
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State | CO
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Zip | 80022-4812
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Country | US
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Telephone | 303-286-8900
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Fax | 303-286-8260
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | OS024214
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0048050
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License Number State | CO
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