Provider Demographics
NPI:1679679229
Name:DELINE, JAMES R (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:DELINE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8490 E CRESCENT PKWY STE 380
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2815
Mailing Address - Country:US
Mailing Address - Phone:303-957-1310
Mailing Address - Fax:303-761-4252
Practice Address - Street 1:2535 S DOWNING ST STE 400
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5851
Practice Address - Country:US
Practice Address - Phone:303-788-8989
Practice Address - Fax:303-788-8982
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2023-06-07
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Provider Licenses
StateLicense IDTaxonomies
CO27384208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01273846Medicaid
CO349508Medicare PIN
CO01273846Medicaid