Provider Demographics
NPI:1477524882
Name:SKORDAS, JAMES (AUD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:SKORDAS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 29TH STREET
Mailing Address - Street 2:SUITE 106
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634
Mailing Address - Country:US
Mailing Address - Phone:970-330-5555
Mailing Address - Fax:970-584-1055
Practice Address - Street 1:6500 29TH STREET
Practice Address - Street 2:SUITE 106
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634
Practice Address - Country:US
Practice Address - Phone:970-330-5555
Practice Address - Fax:970-584-1055
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO147231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO86430327Medicaid
CO86430327Medicaid
COC802959Medicare PIN