Provider Demographics
NPI:1215198593
Name:NOVAK, JOHN STANLEY (PA-C)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:STANLEY
Last Name:NOVAK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7951 E MAPLEWOOD AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4723
Mailing Address - Country:US
Mailing Address - Phone:303-930-7800
Mailing Address - Fax:303-930-7860
Practice Address - Street 1:1700 S POTOMAC ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5405
Practice Address - Country:US
Practice Address - Phone:303-418-7600
Practice Address - Fax:303-750-3137
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2016-08-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO1620363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant