Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | DR.0058196 | CO |
NPI | 1083721971 |
---|---|
Provider Name | Dr. Paul D Boone |
First Address | Denver, CO 80217-5693 |
Second Address | Littleton, CO 80122-2641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 16/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
197312501 | (05) | TX |
8BM350 | BCBSTX (01) | TX |
H06643 | (02) |