Provider Demographics
NPI:1922085794
Name:HARNED, ROGER II (MD)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:
Last Name:HARNED
Suffix:II
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 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:303-493-7000
Mailing Address - Fax:303-493-7202
Practice Address - Street 1:13123 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7106
Practice Address - Country:US
Practice Address - Phone:720-777-8509
Practice Address - Fax:720-777-7264
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2018-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO343642085R0202X
CODR.00343642085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104686196Medicaid
AZ456253Medicaid
IA1513408Medicaid
ID805250900Medicaid
WY114872900Medicaid
MT0070771Medicaid
KS100180290BMedicaid
WA8372781Medicaid
CAXPY196675Medicaid
NM72457554Medicaid
CO01343649Medicaid
TX057597902Medicaid
OK100063590AMedicaid
IA1513408Medicaid
CO01343649Medicaid