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NPI Code Detail

MEDICARE: DR. ROLLIN VAUGHN ODEN MD

MEDICARE: DR. ROLLIN VAUGHN ODEN 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
1207QA0401XAddiction Medicine (Family Medicine) PhysicianDR.0056337CO
2207Q00000XFamily Medicine PhysicianDR.0056337CO

General Provider Information

NPI Number : 1245209147
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROLLIN VAUGHN ODEN MD
Provider Business Mailing Address
First Line : 2111 CHAMPA ST
Second Line :
City : DENVER
State : CO
Zip : 80205-2529
Country : US
Telephone Number : 303-293-2220
Fax Number :
Provider Business Practice Location Address
First Line : 2130 STOUT ST
Second Line :
City : DENVER
State : CO
Zip : 80205-2827
Country : US
Telephone Number : 303-293-2220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2006
Last Update Date : 06/21/2024

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Directions to “ DR. ROLLIN VAUGHN ODEN MD” Practice Location

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