Provider Demographics
NPI:1972506863
Name:SOPHOCLES, ARIS MICHAEL II (MD)
Entity Type:Individual
Prefix:DR
First Name:ARIS
Middle Name:MICHAEL
Last Name:SOPHOCLES
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1340 LEYDEN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-2805
Mailing Address - Country:US
Mailing Address - Phone:303-320-8686
Mailing Address - Fax:303-320-1828
Practice Address - Street 1:1340 LEYDEN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-2805
Practice Address - Country:US
Practice Address - Phone:303-320-8686
Practice Address - Fax:303-320-1828
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO17154207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01171545Medicaid
CO06D0513838OtherCLIA NUMBER
CO17154OtherSTATE MEDICAL LICENSE
CO17154OtherSTATE MEDICAL LICENSE
CO01171545Medicaid
COD23291Medicare UPIN