Provider Demographics
NPI:1811213838
Name:GOTTLIEB, JAMES LAING (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LAING
Last Name:GOTTLIEB
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 1:4745 ARAPAHOE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1082
Mailing Address - Country:US
Mailing Address - Phone:303-938-4750
Mailing Address - Fax:
Practice Address - Street 1:4745 ARAPAHOE AVE STE 200
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1082
Practice Address - Country:US
Practice Address - Phone:303-938-4750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0062037208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics