Organization
INNOVATIVE CANCER CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRY D BLYTON MD (PRESIDENT)
(303) 570-2760
Entity
Organization
Contact information
Practice address
5275 DTC PKWY, GREENWOOD VILLAGE, CO 80111-2772
(303) 570-2760
(303) 770-0792
Mailing address
4704 HARLAN ST, DENVER, CO 80212-7415
(720) 382-1008
(720) 382-1012
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
39830
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86231774
—
CO
Enumeration date
08/08/2016
Last updated
08/08/2016
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