Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 36891 | CO |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 36891 | CO |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 36891 | CO |
N | 2086S0105X | Surgery of the Hand | 36891 | CO |
N | 2086S0129X | Vascular Surgeon | 36891 | CO |
NPI | 1487663167 |
---|---|
Provider Name | Richard Schell Idler |
First Address | Colorado Springs, CO 80920-7835 |
Second Address | Colorado Springs, CO 80920-7835 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 05/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100078690 | (05) | IN |
30301033 | (05) | CO |