Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 29908 | CO |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 29908 | CO |
NPI | 1720115777 |
---|---|
Provider Name | Dr. Gary L Mcdonald |
First Address | Denver, CO 80247-1314 |
Second Address | Lafayette, CO 80026-3370 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 21/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009909 | KAISER-COMMERCIAL NUMBER (01) | |
01299080 | (05) | CO |
F88119 | (02) | CO |