Provider Demographics
NPI:1770962250
Name:SHARP PODIATRIC MEDICINE AND SURGERY
Entity type:Organization
Organization Name:SHARP PODIATRIC MEDICINE AND SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST / MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:303-662-1600
Mailing Address - Street 1:10103 RIDGEGATE PKWY
Mailing Address - Street 2:SUITE 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:SUITE 309
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5520
Practice Address - Country:US
Practice Address - Phone:303-662-1600
Practice Address - Fax:303-662-1008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSA.0001955246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COSA.0001955OtherSURGICAL ASSISTANT