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NPI Code Detail

MEDICARE: DR. JAMES STICKNEY WARSON MD

MEDICARE: DR. JAMES STICKNEY WARSON 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
1204D00000XNeuromusculoskeletal Medicine & OMM Physician21871CO
2207T00000XNeurological Surgery Physician21871CO

General Provider Information

NPI Number : 1417247164
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES STICKNEY WARSON MD
Provider Business Mailing Address
First Line : 1313 RIVERSIDE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-4352
Country : US
Telephone Number : 970-493-1292
Fax Number :
Provider Business Practice Location Address
First Line : 1313 RIVERSIDE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-4352
Country : US
Telephone Number : 970-493-1292
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2011
Last Update Date : 04/14/2011

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