Provider Demographics
NPI:1801003355
Name:SCHECHTER, PHILIP AARON (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:AARON
Last Name:SCHECHTER
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:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:CRESTONE
Mailing Address - State:CO
Mailing Address - Zip Code:81131-0580
Mailing Address - Country:US
Mailing Address - Phone:719-256-6789
Mailing Address - Fax:303-839-1433
Practice Address - Street 1:1534 CENTENNIAL OVERLOOK
Practice Address - Street 2:
Practice Address - City:CRESTONE
Practice Address - State:CO
Practice Address - Zip Code:81131-0580
Practice Address - Country:US
Practice Address - Phone:719-256-6789
Practice Address - Fax:719-256-6788
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO202842084A0401X, 208600000X, 2086S0102X, 2086S0127X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20284OtherMEDICAL LICENSE