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General NPI Number Information
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NPI Number | 1922005610
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Entity Type | Organization
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Legal Business Name | WILLIAM G SELF JR MD PC
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 8403 BRYANT ST
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City | WESTMINSTER
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State | CO
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Zip | 80031-3809
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Country | US
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Telephone | 303-426-4810
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Fax | 303-426-8708
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Provider Business Mailing Address
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Address Line | 8403 BRYANT ST
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City | WESTMINSTER
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State | CO
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Zip | 80031-3809
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Country | US
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Telephone | 303-426-4810
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Fax | 303-426-8708
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | JAMES E MONTGOMERY
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Credential | MD
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Telephone | 303-426-4810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number |
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License Number State |
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