Provider Demographics
NPI:1326058215
Name:DRS CLEVELAND & HUTCHISON PC
Entity Type:Organization
Organization Name:DRS CLEVELAND & HUTCHISON PC
Other - Org Name:ASSOCIATED SURGEONS MD PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:D
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-480-3565
Mailing Address - Street 1:2460 W 26TH AVENUE
Mailing Address - Street 2:420 C
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5308
Mailing Address - Country:US
Mailing Address - Phone:303-480-3565
Mailing Address - Fax:303-480-5066
Practice Address - Street 1:2460 W 26TH AVENUE
Practice Address - Street 2:420 C
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5308
Practice Address - Country:US
Practice Address - Phone:303-480-3565
Practice Address - Fax:303-480-5066
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DRS CLEVELAND & HUTCHISON PC DBA ASSOCIATED SURGEONS, MD, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COTAX ID208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04013645Medicaid
KS110022OtherBC/BS GROUP NUMBER
AZ875396Medicaid
KS200003650AMedicaid
CO29683OtherBC/BS GROUP NUMBER
WY109146800Medicaid
KS200003650BMedicaid
NE=========00Medicaid
CO04013645Medicaid
KS200003650BMedicaid
COCD8961Medicare ID - Type UnspecifiedRAILROAD MEDICARE GROUP #
AZ875396Medicaid