Provider Demographics
NPI:1144697673
Name:COLORADO DERMATOLOGY PC
Entity type:Organization
Organization Name:COLORADO DERMATOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DENHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-683-3235
Mailing Address - Street 1:6660 TIMBERLINE RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-5345
Mailing Address - Country:US
Mailing Address - Phone:303-683-3235
Mailing Address - Fax:303-683-3236
Practice Address - Street 1:6660 TIMBERLINE RD
Practice Address - Street 2:SUITE 140
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-5345
Practice Address - Country:US
Practice Address - Phone:303-683-3235
Practice Address - Fax:303-683-3236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0051289207ND0900X, 207NP0225X, 207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Multi-Specialty
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric DermatologyGroup - Multi-Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty