Provider Demographics
NPI:1427189927
Name:DANEY, DEVON C (MD)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:C
Last Name:DANEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MERCADO ST STE 160
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7309
Mailing Address - Country:US
Mailing Address - Phone:970-385-9850
Mailing Address - Fax:970-385-9854
Practice Address - Street 1:1 MERCADO ST STE 160
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7309
Practice Address - Country:US
Practice Address - Phone:970-385-9850
Practice Address - Fax:970-385-9854
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41673207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO24752061Medicaid
CO24752061Medicaid
COCOA100503Medicare PIN