Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 125055764 | IL |
Y | 207T00000X | Neurosurgeon | DR.0056991 | CO |
NPI | 1013238419 |
---|---|
Provider Name | Dr. Allan Douglas Nanney III |
First Address | Boulder, CO 80301-3362 |
Second Address | Colorado Springs, CO 80907-6819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2010 |
Last Update Date | 14/12/2020 |