Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 29310 | TX |
N | 213EG0000X | General Practice | 29310 | TX |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DEN.00203955 | CO |
NPI | 1013358985 |
---|---|
Provider Name | Dr. Austin Yeager Ivey |
First Address | Denver, CO 80202-1475 |
Second Address | Denver, CO 80202-1475 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2013 |
Last Update Date | 12/01/2022 |