Provider Demographics
NPI:1205827979
Name:SHARP, JOHN A (DPM)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:SHARP
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10103 RIDGEGATE PKWY
Mailing Address - Street 2:#309
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5520
Mailing Address - Country:US
Mailing Address - Phone:303-662-1600
Mailing Address - Fax:303-662-1008
Practice Address - Street 1:10103 RIDGEGATE PKWY
Practice Address - Street 2:#309
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124
Practice Address - Country:US
Practice Address - Phone:303-662-1600
Practice Address - Fax:303-662-1008
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPOD.0000617213ES0103X
CO0000617213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U62949Medicare UPIN
COC807868Medicare PIN