Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MT201628 | PA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | DR.0066140 | CO |
NPI | 1316207970 |
---|---|
Provider Name | Mark Greyson |
First Address | Aurora, CO 80045 |
Second Address | Aurora, CO 80045-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2012 |
Last Update Date | 23/09/2021 |