Provider Demographics
NPI:1659451300
Name:DAWN M. STANLEY, M. D., PC
Entity Type:Organization
Organization Name:DAWN M. STANLEY, M. D., PC
Other - Org Name:DAWN M. STANLEY, M.D., P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LEILA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-225-4220
Mailing Address - Street 1:10099 RIDGEGATE PKWY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5531
Mailing Address - Country:US
Mailing Address - Phone:303-225-4220
Mailing Address - Fax:303-217-5886
Practice Address - Street 1:10099 RIDGEGATE PKWY
Practice Address - Street 2:SUITE 120
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5531
Practice Address - Country:US
Practice Address - Phone:303-225-4220
Practice Address - Fax:303-217-5886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43280207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO13536362Medicaid
COH87359Medicare UPIN
CO13536362Medicaid