Provider Demographics
NPI:1134414188
Name:BRUBAKER, MORGAN L (DO)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:L
Last Name:BRUBAKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 S CLARKSON ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2811
Mailing Address - Country:US
Mailing Address - Phone:303-789-8220
Mailing Address - Fax:303-789-8470
Practice Address - Street 1:3425 S CLARKSON ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2811
Practice Address - Country:US
Practice Address - Phone:303-789-8220
Practice Address - Fax:303-789-8470
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO56784208100000X
CO5426208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO505021YSSSMedicare PIN