Provider Demographics
NPI:1578584652
Name:SORKIN DERMATOLOGY ASSOCIATES PROFESSIONAL LLC.
Entity Type:Organization
Organization Name:SORKIN DERMATOLOGY ASSOCIATES PROFESSIONAL LLC.
Other - Org Name:COLORADO DERMATOLOGY SPECIALISTS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MEG
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-850-9715
Mailing Address - Street 1:3540 S POPLAR STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1364
Mailing Address - Country:US
Mailing Address - Phone:303-850-9715
Mailing Address - Fax:303-850-0649
Practice Address - Street 1:3540 S POPLAR STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-1364
Practice Address - Country:US
Practice Address - Phone:303-850-9715
Practice Address - Fax:303-850-0649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COSO53849OtherBLUE SHIELD
CO63984776Medicaid
COSO53849OtherBLUE SHIELD