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NPI Code Detail

MEDICARE: DR. LISA FOLEY BENNETT M.D.

MEDICARE: DR. LISA FOLEY BENNETT 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
12086S0129XVascular Surgery Physician57562CO

General Provider Information

NPI Number : 1932423688
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA FOLEY BENNETT M.D.
Provider Business Mailing Address
First Line : 950 E HARVARD AVE STE 550
Second Line :
City : DENVER
State : CO
Zip : 80210-7000
Country : US
Telephone Number : 303-778-6527
Fax Number :
Provider Business Practice Location Address
First Line : 950 E HARVARD AVE STE 550
Second Line :
City : DENVER
State : CO
Zip : 80210-7000
Country : US
Telephone Number : 303-778-6527
Fax Number : 303-733-1288
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2010
Last Update Date : 02/19/2020

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