ENRIQUEZ, LOUIE SZEGLIN (MD, JD)

Provider Demographics

• NPI: 1902072143
• Name: ENRIQUEZ, LOUIE SZEGLIN (MD, JD)
• Entity Type: Individual
• Prefix: DR
• First Name: LOUIE
• Middle Name: SZEGLIN
• Last Name: ENRIQUEZ
• Gender: M
• Credentials: MD, JD
• Other - Prefix: DR
• Other - First Name: LOUIE
• Other - Middle Name: ANTHONY
• Other - Last Name: ENRIQUEZ
• Other - Last Name Type: Former Name
• Other - Credentials: MD,JD
• Mailing Address - Street 1: 10800 E GEDDES AVE STE 300
• Mailing Address - City: ENGLEWOOD
• Mailing Address - State: CO
• Mailing Address - Zip Code: 80112-3895
• Mailing Address - Country: US
• Mailing Address - Phone: 303-761-9190
• Mailing Address - Fax: 720-874-4462
• Practice Address - Street 1: 10800 E GEDDES AVE STE 300
• Practice Address - City: ENGLEWOOD
• Practice Address - State: CO
• Practice Address - Zip Code: 80112-3895
• Practice Address - Country: US
• Practice Address - Phone: 303-761-9190
• Practice Address - Fax: 720-874-4462
• Is Sole Proprietor?: No
• Enumeration Date: 2008-05-07
• Last Update Date: 2022-12-09

Provider Licenses

State	License ID	Taxonomies
OH	57.007488	2085R0202X
OH	35091905	2085R0202X
NE	25359	2085R0202X
KS	04-36449	2085R0202X
HI	MD17509	2085R0202X
CO	47463	2085R0202X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology

Provider Identifiers

State	Identifier ID	ID Type	Issuer
NE	10025709000	Medicaid
NV	1902072143	Medicaid
AZ	470751	Medicaid
CA	1902072143	Medicaid
MT	1902072143	Medicaid
KS	200626050A	Medicaid
OH	2832715	Medicaid
NE	84059792913	Medicaid
WY	1902072143	Medicaid
NM	38300877	Medicaid
CO	88939049	Medicaid
NE	84059792913	Medicaid
CO	P00779051	Medicare PIN
NE	NA2517059	Medicare PIN
NE	NA1215058	Medicare PIN
CO	392327ZLJ3	Medicare PIN
WY	1902072143	Medicaid
NE	NA1214058	Medicare PIN
CO	P00813101	Medicare PIN
KS	111257037	Medicare PIN
OH	2832715	Medicaid
NV	1902072143	Medicaid
NM	38300877	Medicaid
KS	P01366584	Medicare PIN
MT	1902072143	Medicaid