Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | DR.0055843 | CO |
Y | 207XS0106X | Orthopaedic Hand Surgeon | DR.0055843 | CO |
NPI | 1093949620 |
---|---|
Provider Name | Dr. John Joseph Mangelson |
First Address | Brighton, CO 80601-4004 |
Second Address | Brighton, CO 80601-4004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2009 |
Last Update Date | 27/07/2016 |