Provider Demographics
NPI:1053324368
Name:NIXON, NED REED JR (MD)
Entity Type:Individual
Prefix:DR
First Name:NED
Middle Name:REED
Last Name:NIXON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 EDISON ST
Mailing Address - Street 2:
Mailing Address - City:BRUSH
Mailing Address - State:CO
Mailing Address - Zip Code:80723-1640
Mailing Address - Country:US
Mailing Address - Phone:970-842-6200
Mailing Address - Fax:970-842-3572
Practice Address - Street 1:2400 EDISON ST
Practice Address - Street 2:
Practice Address - City:BRUSH
Practice Address - State:CO
Practice Address - Zip Code:80723-1640
Practice Address - Country:US
Practice Address - Phone:970-842-6200
Practice Address - Fax:970-842-3572
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38949207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO47927348Medicaid
G15511Medicare UPIN
COCO304084Medicare PIN
COC522578Medicare PIN
COCO304083Medicare PIN