Individual
DR. CHARLES PADDACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2848 S LAKERIDGE TRL, BOULDER, CO 80302-9374
(720) 519-0949
(720) 519-0948
Mailing address
2848 S LAKERIDGE TRL, BOULDER, CO 80302-9374
(720) 519-0949
(720) 519-0948
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
46807
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
788111800
—
MD
Enumeration date
01/22/2007
Last updated
12/15/2021
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