Provider Demographics
NPI:1780991463
Name:PRESNELL, RICHARD WESLEY (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WESLEY
Last Name:PRESNELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2413 W 107TH DR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-3160
Mailing Address - Country:US
Mailing Address - Phone:303-955-0573
Mailing Address - Fax:303-284-8829
Practice Address - Street 1:2413 W 107TH DR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-3160
Practice Address - Country:US
Practice Address - Phone:303-955-0573
Practice Address - Fax:303-284-8829
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO45675207R00000X
GA25250207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine