MEDICARE: DR. PAUL S DOCKTOR M.D.

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	207X00000X	Orthopaedic Surgery Physician	0000577	CO

General Provider Information

NPI Number	:	1730152091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL S DOCKTOR M.D.

Provider Business Mailing Address
First Line	:	2563 S MILWAUKEE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-6214
Country	:	US
Telephone Number	:	303-300-9500
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 BROADWAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-2526
Country	:	US
Telephone Number	:	303-523-8700
Fax Number	:

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	03/06/2014

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