Provider Demographics
NPI:1508839333
Name:ABBOTT, RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:ABBOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:
Other - Last Name:ABBOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8000 E MAPLEWOOD AVE
Mailing Address - Street 2:BUILDING 5 SUITE 200
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4727
Mailing Address - Country:US
Mailing Address - Phone:303-438-3999
Mailing Address - Fax:720-439-9500
Practice Address - Street 1:8000 E MAPLEWOOD AVE
Practice Address - Street 2:BUILDING 5 SUITE 200
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-4727
Practice Address - Country:US
Practice Address - Phone:303-438-3999
Practice Address - Fax:720-439-9500
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34325207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP01140843OtherRAIL ROAD MEDICARE
CO01343250Medicaid
COP01140843OtherRAIL ROAD MEDICARE