Provider Demographics
NPI:1710910732
Name:PEACE OF MIND NEUROLOGY, P.C.
Entity Type:Organization
Organization Name:PEACE OF MIND NEUROLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:TREVOR
Authorized Official - Last Name:MCNUTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-283-6573
Mailing Address - Street 1:7720 S BROADWAY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2632
Mailing Address - Country:US
Mailing Address - Phone:720-283-6573
Mailing Address - Fax:720-283-8108
Practice Address - Street 1:7720 S BROADWAY
Practice Address - Street 2:SUITE 150
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2632
Practice Address - Country:US
Practice Address - Phone:720-283-6573
Practice Address - Fax:720-283-8108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO391062084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC802495Medicare PIN