Provider Demographics
NPI:1144240094
Name:GREGORY, DARREN G (MD)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:G
Last Name:GREGORY
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:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:303-493-7000
Mailing Address - Fax:303-493-7202
Practice Address - Street 1:1675 URSULA ST
Practice Address - Street 2:MAIL STOP F.731, BOX 6510
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7402
Practice Address - Country:US
Practice Address - Phone:720-848-2500
Practice Address - Fax:720-848-5014
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35514207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO95800549Medicaid
CO95800549Medicaid
CO467948Medicare ID - Type Unspecified