Provider Demographics
NPI:1558446583
Name:QUILLEN, JAMES E (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:QUILLEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1800 15TH ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-4500
Mailing Address - Country:US
Mailing Address - Phone:970-392-0900
Mailing Address - Fax:970-506-3796
Practice Address - Street 1:1900 BOISE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-5004
Practice Address - Country:US
Practice Address - Phone:970-203-2400
Practice Address - Fax:970-506-3796
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2011-06-28
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Provider Licenses
StateLicense IDTaxonomies
CO49471207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO91752051Medicaid
COA104798Medicare PIN