Provider Demographics
NPI: | 1356389993 |
---|---|
Name: | STRICKLAND, DARWIN JAN (DO) |
Entity type: | Individual |
Prefix: | DR |
First Name: | DARWIN |
Middle Name: | JAN |
Last Name: | STRICKLAND |
Suffix: | |
Gender: | M |
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: | 9669 NO HURON ST |
Mailing Address - Street 2: | SUITE 202 |
Mailing Address - City: | DENVER |
Mailing Address - State: | CO |
Mailing Address - Zip Code: | 80260-5669 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 303-428-7509 |
Mailing Address - Fax: | 303-429-0032 |
Practice Address - Street 1: | 9669 NO HURON ST |
Practice Address - Street 2: | SUITE 202 |
Practice Address - City: | DENVER |
Practice Address - State: | CO |
Practice Address - Zip Code: | 80260-5669 |
Practice Address - Country: | US |
Practice Address - Phone: | 303-428-7509 |
Practice Address - Fax: | 303-429-0032 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-06-04 |
Last Update Date: | 2008-04-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CO | 15236 | 207Q00000X |
CO | 15263 | 207QG0300X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | |
No | 207QG0300X | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CO | 01152636 | Medicaid | |
CO | CJ7018 | Medicare PIN | |
CO | 01152636 | Medicaid |