Provider Demographics
NPI:1740366079
Name:AUSTIN, PAUL D (DC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:D
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 W SOUTH BOULDER RD
Mailing Address - Street 2:STE 201A
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-8952
Mailing Address - Country:US
Mailing Address - Phone:303-665-5405
Mailing Address - Fax:303-664-1697
Practice Address - Street 1:1120 W SOUTH BOULDER RD
Practice Address - Street 2:STE 201A
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-8952
Practice Address - Country:US
Practice Address - Phone:303-665-5405
Practice Address - Fax:303-664-1697
Is Sole Proprietor?:No
Enumeration Date:2006-10-30
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2738111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO441538Medicare ID - Type Unspecified
COU18587Medicare UPIN