MEDICARE: ANN MARY JOSEPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	205603	LA
2	2084P0800X	Psychiatry Physician	55388	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215179049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN MARY JOSEPH

Provider Business Mailing Address
First Line	:	777 BANNOCK ST
Second Line	:	MC 3240
City	:	DENVER
State	:	CO
Zip	:	80204-4507
Country	:	US
Telephone Number	:	303-602-2714
Fax Number	:	303-602-2719

Provider Business Practice Location Address
First Line	:	777 BANNOCK ST
Second Line	:	MC 3240
City	:	DENVER
State	:	CO
Zip	:	80204-4507
Country	:	US
Telephone Number	:	303-602-2714
Fax Number	:	303-602-2719

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2009
Last Update Date	:	06/29/2016

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Directions to “ ANN MARY JOSEPH ” Practice Location

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