Provider Demographics
NPI:1629020144
Name:ALBERT, JAMES D (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:ALBERT
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 1:9 EL ENCANTO DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4310
Mailing Address - Country:US
Mailing Address - Phone:719-477-1711
Mailing Address - Fax:719-477-0646
Practice Address - Street 1:10807 NEW ALLEGIENCE DR
Practice Address - Street 2:STE 450
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3722
Practice Address - Country:US
Practice Address - Phone:719-550-8346
Practice Address - Fax:719-550-0304
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29347174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COALA29527OtherBLUE SHIELD
COC801635Medicare PIN
COALA29527OtherBLUE SHIELD