1275583759 NPI number — JAMES GARLAND DO

Table of content: JAMES GARLAND DO (NPI 1275583759)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275583759 NPI number — JAMES GARLAND DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARLAND
Provider First Name:
JAMES
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
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:
1275583759
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 52650
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MESA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85208-0133
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-206-5902
Provider Business Mailing Address Fax Number:
480-466-7536

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
276 GALAPAGO ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80223-1325
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-892-6436
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/12/2006

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: 207L00000X , with the licence number:  A-2089-17 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: A6518 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: A6518 . This is a "ANTHEM/BLUE CROSS" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 001224427 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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