Provider Demographics
NPI:1114985561
Name:PADYK, PAUL CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:CHRISTOPHER
Last Name:PADYK
Suffix:
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 1:167 1/2 LITTLE PARK RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81503-1723
Mailing Address - Country:US
Mailing Address - Phone:970-257-9036
Mailing Address - Fax:
Practice Address - Street 1:DEPT #0861
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80256-0001
Practice Address - Country:US
Practice Address - Phone:866-898-7136
Practice Address - Fax:616-975-9824
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33218207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTT0115Medicaid
CO01332188Medicaid
CO930065955OtherRAILROAD
CO930065955OtherRAILROAD
COG03025Medicare UPIN