Provider Demographics
NPI:1710962295
Name:DENVER EAR ASSOCIATES
Entity Type:Organization
Organization Name:DENVER EAR ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALRATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-788-7880
Mailing Address - Street 1:701 E HAMPDEN AVE STE 415
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2759
Mailing Address - Country:US
Mailing Address - Phone:303-788-7880
Mailing Address - Fax:303-788-7883
Practice Address - Street 1:701 E HAMPDEN AVE STE 415
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2759
Practice Address - Country:US
Practice Address - Phone:303-788-7880
Practice Address - Fax:303-788-7883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-07
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY303339OtherBCBS
WY107643400Medicaid
CO04008975Medicaid