MEDICARE: DOUGLAS SIKES

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	163W00000X	Registered Nurse	0109006	CO

General Provider Information

NPI Number	:	1265836548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS SIKES

Provider Business Mailing Address
First Line	:	1988 SANDHURST DR
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-2363
Country	:	US
Telephone Number	:	303-549-4088
Fax Number	:

Provider Business Practice Location Address
First Line	:	2550 S PARKER RD
Second Line	:	WATERPARK III
City	:	DENVER
State	:	CO
Zip	:	80014-1622
Country	:	US
Telephone Number	:	303-636-2340
Fax Number	:

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

Provider Enumeration Date	:	10/15/2014
Last Update Date	:	10/15/2014

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Directions to “ DOUGLAS SIKES ” Practice Location

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