Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 25691 | CO |
NPI | 1093717902 |
---|---|
Provider Name | Donald James Sceats JR. |
First Address | Colorado Springs, CO 80907-5302 |
Second Address | Colorado Springs, CO 80907-5302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 18/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01256916 | (05) | CO |
E54800 | (02) | CO |