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NPI Code Detail

MEDICARE: DR. DAVID W. TERRY D.O.

MEDICARE: DR. DAVID W. TERRY D.O.
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
1207Q00000XFamily Medicine Physician23358CO

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 : 1528185972
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID W. TERRY D.O.
Provider Business Mailing Address
First Line : 603 281/4 RD
Second Line : SUITE 4
City : GRAND JUNCTION
State : CO
Zip : 81506
Country : US
Telephone Number : 970-263-2600
Fax Number : 970-263-2692
Provider Business Practice Location Address
First Line : 603 28 1/4 RD
Second Line :
City : GRAND JUNCTION
State : CO
Zip : 81506-6019
Country : US
Telephone Number : 970-263-2600
Fax Number : 970-263-2692
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2007
Last Update Date : 05/16/2012

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