Provider Demographics
NPI:1518257427
Name:SHIRLEY, JOEL BRIAN (DO)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:BRIAN
Last Name:SHIRLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13123 E 16TH AVE # 311
Mailing Address - Street 2:ATTN: JENNIFER REED
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7106
Mailing Address - Country:US
Mailing Address - Phone:720-777-6132
Mailing Address - Fax:720-777-7341
Practice Address - Street 1:13123 E 16TH AVE # 311
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-6132
Practice Address - Fax:720-777-7341
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NMA-1834-142080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program