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NPI Code Detail

MEDICARE: DENVER INTEGRATED IMAGING LLC

MEDICARE: DENVER INTEGRATED IMAGING LLC
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
12085R0202XDiagnostic Radiology Physician

Other Identifiers

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

General Provider Information

NPI Number : 1487650172
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENVER INTEGRATED IMAGING LLC
Provider Business Mailing Address
First Line : 12520 GRANT DR
Second Line :
City : THORNTON
State : CO
Zip : 80241-2406
Country : US
Telephone Number : 303-252-4363
Fax Number : 303-252-4319
Provider Business Practice Location Address
First Line : 939 BROADWAY
Second Line :
City : DENVER
State : CO
Zip : 80203-2705
Country : US
Telephone Number : 720-932-0930
Fax Number : 720-932-0931
Authorized Official
Title or Position : CEO
Name : MR. DON BALLARD
Credential :
Telephone Number : 303-252-4363
Provider Enumeration Date : 06/27/2005
Last Update Date : 03/22/2012

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