Provider Demographics
NPI:1649251836
Name:BLISS, DAVID PAUL JR (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:BLISS
Suffix:JR
Gender:M
Credentials:MD
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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:
Practice Address - Street 1:4125 BRIARGATE PARKWAY
Practice Address - Street 2:CHILDREN'S HOSPITAL COLORADO AT BRIARGATE
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920
Practice Address - Country:US
Practice Address - Phone:719-305-9035
Practice Address - Fax:719-305-9036
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2016-08-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK13692086S0120X
CODR.00570282086S0120X
MO20100209152086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX820908OtherBLUE CROSS
TX102614802Medicaid
TX153410005OtherPACIFIARE
TX0134405OtherUNITED HEALTH CARE
TX10028087OtherAMERIGROUP
TX102614804Medicaid
TX102614805OtherCSHCN
TX114083OtherSUPERIOR CHIP
TX282728OtherPHCS
TX8155830002OtherCIGNA
TX41621OtherAETNA MEDICAID
TX4620671OtherAETNA
TX389963OtherONE HEALTH PLAN
TX102614804Medicaid