Provider Demographics
NPI:1578616504
Name:GIESSEL, BARTON ELGIN (MD)
Entity Type:Individual
Prefix:DR
First Name:BARTON
Middle Name:ELGIN
Last Name:GIESSEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5709 COUNTY ROAD 14
Mailing Address - Street 2:
Mailing Address - City:DEL NORTE
Mailing Address - State:CO
Mailing Address - Zip Code:81132-9706
Mailing Address - Country:US
Mailing Address - Phone:469-337-6069
Mailing Address - Fax:
Practice Address - Street 1:1033 2ND AVE
Practice Address - Street 2:
Practice Address - City:MONTE VISTA
Practice Address - State:CO
Practice Address - Zip Code:81144-1737
Practice Address - Country:US
Practice Address - Phone:719-852-8827
Practice Address - Fax:719-852-2739
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO61317207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO725506OtherMEDICARE
TX8825B7Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER