Provider Demographics
NPI:1447769351
Name:LIPKO, BARTLOMIEJ (PA-C)
Entity Type:Individual
Prefix:
First Name:BARTLOMIEJ
Middle Name:
Last Name:LIPKO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:BARTEK
Other - Middle Name:
Other - Last Name:LIPKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-4123
Mailing Address - Fax:970-490-4173
Practice Address - Street 1:9475 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-7802
Practice Address - Country:US
Practice Address - Phone:303-470-4061
Practice Address - Fax:303-470-4062
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-22
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363A00000X
COPA.0005730363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant