1679035968 NPI number — DR. MEGAN JO TOWNSEND MD/MPP

Table of content: DR. MEGAN JO TOWNSEND MD/MPP (NPI 1679035968)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679035968 NPI number — DR. MEGAN JO TOWNSEND MD/MPP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOWNSEND
Provider First Name:
MEGAN
Provider Middle Name:
JO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD/MPP
Provider Gender Code:
F

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:
1679035968
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 35380
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89133-5380
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-763-4900
Provider Business Mailing Address Fax Number:
303-763-5495

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4500 E 9TH AVE STE 320
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:
80220-3922
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-332-0212
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/04/2019

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: 207Q00000X , with the licence number:  DR.0069020 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X , with the licence number: TL00075666 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: DR.0028983 , 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: DR.0069020 . This is a "COLORADO DR LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: DR.0028983 . This is a "COLORADO LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: TL0007566 . This is a "COLORADO TRAINING LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".