Individual
DAVID BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11000 E 45TH AVE, DENVER, CO 80239-3004
(303) 404-4022
Mailing address
491 JOSEPHINE ST, DENVER, CO 80206-4208
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
24614
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
76079538
—
CO
Enumeration date
05/14/2007
Last updated
07/08/2007
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