Provider Demographics
NPI:1700159555
Name:ORMOND, DAVID RYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RYAN
Last Name:ORMOND
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:12631 E 17TH AVE
Mailing Address - Street 2:ACADEMIC OFFICE 1, ROOM 5001, MAILSTOP C307
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-2527
Mailing Address - Country:US
Mailing Address - Phone:303-724-2284
Mailing Address - Fax:303-724-2300
Practice Address - Street 1:12631 E 17TH AVE
Practice Address - Street 2:ACADEMIC OFFICE 1, ROOM 5001, MAILSTOP C307
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2527
Practice Address - Country:US
Practice Address - Phone:303-724-2284
Practice Address - Fax:303-724-2300
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA67516207T00000X
NY267037207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003125626BMedicaid
GA202I147714Medicare Oscar/Certification
GA003125626BMedicaid