Provider Demographics
NPI:1003496712
Name:BRIDGES, PAUL (DO)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:BRIDGES
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1520 N SENATE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2213
Mailing Address - Country:US
Mailing Address - Phone:317-962-0857
Mailing Address - Fax:317-962-5479
Practice Address - Street 1:1925 MOUNTAIN VIEW AVE
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3128
Practice Address - Country:US
Practice Address - Phone:720-494-3121
Practice Address - Fax:720-494-3108
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2024-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0073669207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine