Provider Demographics
NPI:1285634121
Name:MCCURRY, ROBERT D (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:MCCURRY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-3506
Mailing Address - Country:US
Mailing Address - Phone:719-275-3000
Mailing Address - Fax:719-275-6939
Practice Address - Street 1:1210 MAIN ST
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-3506
Practice Address - Country:US
Practice Address - Phone:719-275-3000
Practice Address - Fax:719-275-6939
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32118207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01321181Medicaid
CO01321181Medicaid
COC536648Medicare PIN