Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 25955 | CO |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 25955 | CO |
NPI | 1225090202 |
---|---|
Provider Name | Douglas J Straehley |
First Address | Golden, CO 80401-9541 |
Second Address | Golden, CO 80401-9541 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 12/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01259555 | (05) | CO |
D24724 | (02) |