Provider Demographics
NPI:1942209937
Name:FRANTZ, SHIRLEY J (MD)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:J
Last Name:FRANTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12250 E ILIFF AVE
Mailing Address - Street 2:#300
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-6318
Mailing Address - Country:US
Mailing Address - Phone:303-306-4321
Mailing Address - Fax:720-524-1551
Practice Address - Street 1:12250 E ILIFF AVE
Practice Address - Street 2:#300
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-6318
Practice Address - Country:US
Practice Address - Phone:303-306-4321
Practice Address - Fax:720-524-1551
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42746207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO76120201Medicaid
COCOA104505Medicare PIN
CO76120201Medicaid
COC40223Medicare UPIN
CO76120201Medicaid
COCOA104505Medicare PIN
CO671001OtherANTHEM BC/BS INSURANCE
CO547438Medicare ID - Type Unspecified