Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 21871 | CO |
Y | 207T00000X | Neurosurgeon | 21871 | CO |
NPI | 1417247164 |
---|---|
Provider Name | Dr. James Stickney Warson |
First Address | Fort Collins, CO 80524-4352 |
Second Address | Fort Collins, CO 80524-4352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2011 |
Last Update Date | 14/04/2011 |