Provider Demographics
NPI:1134102759
Name:BRATZ, ERIC T
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:T
Last Name:BRATZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ERIC
Other - Middle Name:T
Other - Last Name:BRATZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:P.O. BOX 173862
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-3862
Mailing Address - Country:US
Mailing Address - Phone:303-306-7783
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:10101 RIDGEGATE PARKWAY
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-9810
Practice Address - Country:US
Practice Address - Phone:720-225-1900
Practice Address - Fax:303-306-7753
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41437207P00000X
CODR.0041437207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO39021084Medicaid
COP00019660OtherRAILROAD MEDICARE
CO498008Medicare PIN
COP00019660OtherRAILROAD MEDICARE