Provider Demographics
NPI:1376747972
Name:GREGORY D. DENZEL, DO
Entity Type:Organization
Organization Name:GREGORY D. DENZEL, DO
Other - Org Name:GREELEY QUICK CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:D
Authorized Official - Last Name:DENZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:970-351-8181
Mailing Address - Street 1:2928 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-5426
Mailing Address - Country:US
Mailing Address - Phone:970-351-8181
Mailing Address - Fax:970-351-0281
Practice Address - Street 1:2928 W 10TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-5426
Practice Address - Country:US
Practice Address - Phone:970-351-8181
Practice Address - Fax:970-351-0281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32068261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01320688Medicaid
CO01320688Medicaid
E96507Medicare UPIN