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General NPI Number Information
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NPI Number | 1932140886
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Entity Type | Organization
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Legal Business Name | JONATHON J DORMISH DPM LLC
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 13701 E MISSISSIPPI AVE SUITE 200
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City | AURORA
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State | CO
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Zip | 80012-6141
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Country | US
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Telephone | 303-364-3222
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Fax |
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Provider Business Mailing Address
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Address Line | 3464 S WILLOW ST SUITE 124
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City | DENVER
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State | CO
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Zip | 80231-4531
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Country | US
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Telephone | 303-755-2900
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Fax | 303-755-0404
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Authorized Official
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Title or Position | PRESIDENT
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Name | JONATHON J DORMISH
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Credential | DPM
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Telephone | 303-364-3222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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