1649306390 NPI number — MICHAEL T. PREECE MD

Table of content: MR. GARY A SWANSON LCPC (NPI 1679676050)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649306390 NPI number — MICHAEL T. PREECE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PREECE
Provider First Name:
MICHAEL
Provider Middle Name:
T.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1649306390
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10800 E GEDDES AVE STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENGLEWOOD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80112-3895
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-761-9190
Provider Business Mailing Address Fax Number:
720-874-4462

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10800 E GEDDES AVE STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ENGLEWOOD
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80112-3895
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-761-9190
Provider Business Practice Location Address Fax Number:
720-874-4462
Provider Enumeration Date:
02/26/2007

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: 2085R0202X , with the licence number:  MD17493 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 54301 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085N0700X , with the licence number: 49846 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085R0202X , with the licence number: 04-34934 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 26147 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: L-227552 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 49001779 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1528962 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1649306390 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1649306390 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1649306390 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1649306390 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200869030A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 860155 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0302451 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1649306390 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1649306390 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1649306390 , issued by the state of ( WY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1649306390 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200653220A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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