Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DEN-9173 | CO |
Y | 213EG0000X | General Practice | DEN-9173 | CO |
NPI | 1003836354 |
---|---|
Provider Name | Dr. Austin Bruce Babcock |
First Address | Sedona, AZ 86336-3578 |
Second Address | Sedona, AZ 86336-3578 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 25/07/2013 |