Provider Demographics
NPI:1780640011
Name:BARON, JAMES GREGORY (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:GREGORY
Last Name:BARON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 N CASCADE AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6262
Mailing Address - Country:US
Mailing Address - Phone:719-636-3937
Mailing Address - Fax:719-636-2241
Practice Address - Street 1:2920 N CASCADE AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6262
Practice Address - Country:US
Practice Address - Phone:719-636-3937
Practice Address - Fax:719-636-2241
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17332207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO180022049OtherRAILROAD MEDICARE
CO01173327Medicaid
CO0362080001OtherPALMETTO GBA
COC07428Medicare PIN
COD23247Medicare UPIN