Larry Avis Bourg in Greenwood Village - Specialist
Larry Avis Bourg - NPI 1205800182
Larry Avis Bourg is a Specialist in Greenwood Village, Colorado. Larry Avis Bourg practices all healthcare services and medical treatments related to Specialist. The NPI Number for Larry Avis Bourg is 1205800182. The last update date is 2023-08-08.
Larry Avis Bourg's current location address is 9250 E Costilla Ave Ste 540, Greenwood Village, Colorado. You can contact this provider via phone number 7206449355. The mailing address for Larry Avis Bourg is 9250 E Costilla Ave Ste 540, Greenwood Village, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Larry Avis Bourg |
|---|---|
| Address | 9250 E Costilla Ave Ste 540, Greenwood Village, Colorado |
| Phone Number | 7206449355 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1205800182 |
|---|---|
| Provider Enumeration Date | 2006-02-15 |
| Last Updated Date | 2023-08-08 |
Provider Mailing Address Detail
| Address | 9250 E Costilla Ave Ste 540 |
|---|---|
| City | Greenwood Village |
| State | Colorado (CO) |
| Post Code | 801123648 |
| Phone Number | 7206449355 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 39560 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 93909365 | CO | -- | |
| 13365 | CO | KAISER COMMERCIAL NUMBER |
Post Comment/ Review Below
What is the Larry Avis Bourg's unique identification number?
The Larry Avis Bourg has been assigned the NPI (National Provider Identifier) Number 1205800182 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete physical address where Larry Avis Bourg is located?
The Larry Avis Bourg is situated at the following address: 9250 E Costilla Ave Ste 540, Greenwood Village, CO, 801123648.
What is the Larry Avis Bourg's specialty and taxonomy code?
The Larry Avis Bourg's specialty is Specialist, and the corresponding taxonomy code is 174400000X.
On what date did the Larry Avis Bourg receive its 1205800182 assignment from the Centers for Medicare & Medicaid Services?
The Larry Avis Bourg was assigned its 1205800182 by the Centers for Medicare & Medicaid Services on 2006-02-15.
As of what date was the information pertaining to Larry Avis Bourg, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Larry Avis Bourg, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2023-08-08.
NPI Number: 1184622524
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