Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 47824 | CO |
Y | 207QS0010X | Family Doctor - Sports Medicine | 47824 | CO |
NPI | 1063567162 |
---|---|
Provider Name | Dr. Richard J Price |
First Address | Grand Junction, CO 81507-2634 |
Second Address | Grand Junction, CO 81507-2634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 03/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H67366 | (02) | CA |