Provider Demographics
NPI:1770557357
Name:LICHFIELD, QUINN T (DO)
Entity type:Individual
Prefix:DR
First Name:QUINN
Middle Name:T
Last Name:LICHFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1400 S POTOMAC ST
Mailing Address - Street 2:SUITE #130
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4528
Mailing Address - Country:US
Mailing Address - Phone:303-752-1157
Mailing Address - Fax:303-752-1236
Practice Address - Street 1:1400 S POTOMAC ST
Practice Address - Street 2:SUITE #130
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4528
Practice Address - Country:US
Practice Address - Phone:303-752-1157
Practice Address - Fax:303-752-1236
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO40957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO27837360Medicaid
COH82379Medicare UPIN