Provider Demographics
NPI:1598727166
Name:LOVATO, RICHARD G (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:G
Last Name:LOVATO
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 1:11700 W 2ND PL
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1704
Mailing Address - Country:US
Mailing Address - Phone:720-321-8080
Mailing Address - Fax:720-321-8081
Practice Address - Street 1:11700 W 2ND PL
Practice Address - Street 2:SUITE 210
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1704
Practice Address - Country:US
Practice Address - Phone:720-321-8080
Practice Address - Fax:720-321-8081
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM99-251174400000X
CODR.0053861208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM004880OtherBLUECROSSBLUESHIELD
NMZ6086Medicaid
NM020043552OtherPALMETTORAILROADMEDICARE
CO18605737Medicaid
CO358792YMMWMedicare UPIN
CO18605737Medicaid