Provider Demographics
NPI:1164432159
Name:TARTAGLIA, LOUIS JR (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:TARTAGLIA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LOUIS
Other - Middle Name:
Other - Last Name:TARTAGLIA
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1708 BOISE AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-4219
Mailing Address - Country:US
Mailing Address - Phone:970-669-6880
Mailing Address - Fax:970-669-0612
Practice Address - Street 1:1708 BOISE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-4219
Practice Address - Country:US
Practice Address - Phone:970-669-6880
Practice Address - Fax:970-669-0612
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO19538207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01195387Medicaid
CW9808Medicare ID - Type Unspecified
CO01195387Medicaid