Provider Demographics
NPI:1265505028
Name:CONAHAN, JAMES BERNARD (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BERNARD
Last Name:CONAHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9330 SOUTH UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126
Mailing Address - Country:US
Mailing Address - Phone:303-346-8400
Mailing Address - Fax:303-346-1785
Practice Address - Street 1:9330 SOUTH UNIVERSITY BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126
Practice Address - Country:US
Practice Address - Phone:303-346-8400
Practice Address - Fax:303-346-1785
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO32608207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01326081Medicaid
COCD4418Medicare PIN
COE81353Medicare UPIN