Provider Demographics
NPI:1316948797
Name:MIGICOVSKY, BARRY (MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:MIGICOVSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3586
Mailing Address - Country:US
Mailing Address - Phone:303-440-3000
Mailing Address - Fax:
Practice Address - Street 1:2750 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3586
Practice Address - Country:US
Practice Address - Phone:303-440-3216
Practice Address - Fax:303-440-3209
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0073276207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL046776600Medicaid
FL046776600Medicaid
FL02938XMedicare ID - Type UnspecifiedMEDICARE NUMBER