Provider Demographics
NPI:1912466962
Name:COMISKEY, DOUG JAMES
Entity Type:Individual
Prefix:
First Name:DOUG
Middle Name:JAMES
Last Name:COMISKEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 S FEDERAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-4837
Mailing Address - Country:US
Mailing Address - Phone:303-935-5652
Mailing Address - Fax:
Practice Address - Street 1:1601 S FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-4837
Practice Address - Country:US
Practice Address - Phone:303-935-5652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty