Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | R-7402 | IA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 48800 | CO |
NPI | 1770791055 |
---|---|
Provider Name | Dr. Jaren M Riley |
First Address | Denver, CO 80237-3486 |
Second Address | Denver, CO 80205-5503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 26/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10025633000 | (05) | NE |
1770791055 | (05) | SD |
1770791055 | (05) | WY |
200320870A | (05) | OK |
58958274 | (05) | CO |