1346276185 NPI number — MR. DAN M BABBEL P.T.

Table of content: MR. DAN M BABBEL P.T. (NPI 1346276185)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346276185 NPI number — MR. DAN M BABBEL P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BABBEL
Provider First Name:
DAN
Provider Middle Name:
M
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346276185
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10700
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND JUNCTION
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81502-5517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-241-5856
Provider Business Mailing Address Fax Number:
970-241-8599

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3150 N 12TH ST
Provider Second Line Business Practice Location Address:
GARDEN LEVEL
Provider Business Practice Location Address City Name:
GRAND JUNCTION
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81506-2863
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-241-5856
Provider Business Practice Location Address Fax Number:
970-241-8599
Provider Enumeration Date:
06/23/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1269 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 650011509 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 840999425001 . This is a "RMHMO" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 840999425 . This is a "TAX ID" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".