Provider Demographics
NPI:1740789668
Name:CIRRUSMD PROVIDER NETWORK
Entity Type:Organization
Organization Name:CIRRUSMD PROVIDER NETWORK
Other - Org Name:CIRRUSMD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-215-4554
Mailing Address - Street 1:3513 BRIGHTON BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80216-3606
Mailing Address - Country:US
Mailing Address - Phone:720-996-0522
Mailing Address - Fax:
Practice Address - Street 1:3000 LAWRENCE ST # 101
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-3422
Practice Address - Country:US
Practice Address - Phone:916-215-4554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-06
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty