1922085794 NPI number — DR. ROGER HARNED II MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922085794 NPI number — DR. ROGER HARNED II MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

HARNED

Provider First Name:

ROGER

Provider Middle Name:

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

II

Provider Credential Text:

MD

Provider Gender Code:

M

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:

1922085794

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

11/17/2018

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 110429

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

AURORA

Provider Business Mailing Address State Name:

CO

Provider Business Mailing Address Postal Code:

80042-0429

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

303-493-7000

Provider Business Mailing Address Fax Number:

303-493-7202

Provider First Line Business Practice Location Address:

13123 E 16TH AVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

AURORA

Provider Business Practice Location Address State Name:

CO

Provider Business Practice Location Address Postal Code:

80045-7106

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

720-777-8509

Provider Business Practice Location Address Fax Number:

720-777-7264

Provider Enumeration Date:

12/22/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085R0202X , with the licence number:  34364 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085P0229X , with the licence number: DR.0034364 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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