Individual
DR. TIFFANY ALEXIS KOONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
8383 W ALAMEDA AVE, LAKEWOOD, CO 80226-3007
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DR.0067866
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029406
KAISER COMMERCIAL NUMBER
CO
05
—
9000183009
—
CO
Enumeration date
03/23/2020
Last updated
09/05/2023
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