MEDICARE: JAVIER GUTIERREZ MD

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	207V00000X	Obstetrics & Gynecology Physician	36491	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	:	1235135385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAVIER GUTIERREZ MD

Provider Business Mailing Address
First Line	:	P.O. BOX 911416
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80291-1416
Country	:	US
Telephone Number	:	970-668-5771
Fax Number	:	970-262-2196

Provider Business Practice Location Address
First Line	:	360 PEAK ONE DRIVE
Second Line	:	STE 260
City	:	FRISCO
State	:	CO
Zip	:	80443
Country	:	US
Telephone Number	:	970-668-5771
Fax Number	:	970-262-2196

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	11/19/2011

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Directions to “ JAVIER GUTIERREZ MD” Practice Location

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